How Many Optometry Schools Should There Be?

[Commando303]

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So, I see in this forum frequent concern over over-supply in optometry, and it seems one cannot go more than a few weeks without seeing a thread pop up that briefly bemoans the openings of new O.D.-granting institutions.

With as much disinterest as I can, I'd like to ask, how many colleges of optometry should there be in the U.S. (yes, include Puerto Rico)? What is, to you, a "good number"?

As a bit of background, as of March 13th, 2011, I believe there are, in the United States (including its territories), 159 medical schools (granting the M.D. and/or D.O.), 20 colleges of optometry (granting the O.D.), and 61 schools of dentistry (granting the D.D.S. and/or D.M.D.). This information may or may not be important to you as you answer; I've simply decided to provide it.

*I realize a legitimate question is, "How many students would be enrolled in the class of each school?" For the sake of simplicity, let's say each class would contain 84 students. This is an average of the first-year enrollment statistics of the 2009–10 academic year (i.e., the "class of 2013") of the twenty schools of optometry (http://www.opted.org/i4a/pages/index.cfm?pageid=3474); the smallest size was 28 (Oklahoma College of Optometry) and the largest was 169 (Pennsylvania College of Optometry).

 

[nc2tarheels]

According to many bitter posters in here, I would guess 1

 

[socal2014]

Over 9,000!

 

[Shnurek]

I think 20 is fine. Just let it sit like that for the next few decades to let the GPA's rise to a commendable level closer to that of dental/med. I know this will not be the case though lol.

BTW can we shut down IAUPR? Its like the Caribbean med school of optometry. lol don't hate me

 

[IndianaOD]

14-15 tops

 

[Ryan_eyeball]

According to many bitter posters in here, I would guess 1

14-15 schools should be sufficient. I'd like to see how you answer after practicing for five years.

 

[nc2tarheels]

14-15 schools should be sufficient. I'd like to see how you answer after practicing for five years.

fyi, I answered 13-16

 

[ATXDesi]

BTW can we shut down IAUPR? Its like the Caribbean med school of optometry. lol don't hate me

Sorry to burst your bubble, not gonna happen.

I think 20 is fine, and with more schools opening along the way and applications down 25% percentage (was chatting with the dean about this), there is no need for these extra schools.

 

[Commando303]

Sorry to burst your bubble, not gonna happen.

I think 20 is fine, and with more schools opening along the way and applications down 25% percentage (was chatting with the dean about this), there is no need for these extra schools.

At which school, and between which enrollment-periods, were applications down 25%?

 

[ATXDesi]

At which school, and between which enrollment-periods, were applications down 25%?

This is what my dean was telling me, she said across the board for the past 2 years..i will double check with her to see if i can get more specifics

either way, im still standing around the 20 range

 

[Commando303]

This is what my dean was telling me, she said across the board for the past 2 years..i will double check with her to see if i can get more specifics

either way, im still standing around the 20 range

That's fine, but, which school are you talking about?

 

[Shnurek]

It is probably true, as many applications now go to the new schools and people are scared about compensation with the whole obamacare thing.

 

[ATXDesi]

That's fine, but, which school are you talking about?

Again re read my post, i said across the board. I don't know which exact schools she was specifically referring too. I will try to find out when i get a chance to speak with her.

 

[IndianaOD]

Sorry to burst your bubble, not gonna happen.

I think 20 is fine, and with more schools opening along the way and applications down 25% percentage (was chatting with the dean about this), there is no need for these extra schools.

That does not surprise me. I think the younger students are more internet savvy and will more easily see the negatives of optometry in its current state of affairs. The return on investment is pretty questionable right now. I know students think most of us are a bunch of cranky ODs but the oversupply does have significant consequences. There is only so much demand to be spread around.

Even most rural areas have plenty of eye care accessablitiy. It is important to note that many rural areas could not support an OD even if one was there. There is supposed to be one OD or OMD per 10,000 people. We are way above that. You can't only count the 40,000 ODs or whatever but also thousands of OMDs, some who run 40-50 patients per day like cattle.

 

[arahnisarahn]

I am sitting here laughing at this thread and how some of us here always need some sort of documentation to every post placed on this site. Grant it, I find some forms of proof to be beneficial; but to harass someone over an issue that wouldn't take more than 5 minutes for you to figure out, is beyond me. Yet very informative, Posts on this forum are not documented contracts.

 

[Commando303]

Again re read my post, i said across the board. I don't know which exact schools she was specifically referring too. I will try to find out when i get a chance to speak with her.

Maybe I misunderstood — it struck me the dean at your college was talking just about her school.

 

[socal2014]

I am sitting here laughing at this thread and how some of us here always need some sort of documentation to every post placed on this site. Grant it, I find some forms of proof to be beneficial; but to harass someone over an issue that wouldn't take more than 5 minutes for you to figure out, is beyond me. Yet very informative, Posts on this forum are not documented contracts.

Well done, young one. In fact, one doesn't even need documentation/proof, as most of it is common sense to any individual who isn't conditioned.

I find it hilarious when people try to argue against:

a) oversupply
b) managed care intervention
c) corporate optometry

and their respectable effects on Optometry. It's like arguing with a parakeet.

 

[webby82]

I think that the smaller independent schools are likely to be swallowed by the larger schools. They might call it a merger or an affiliation, but there is always a winner and a loser.

 

[Visionary]

I think that the smaller independent schools are likely to be swallowed by the larger schools. They might call it a merger or an affiliation, but there is always a winner and a loser.

I'd argue that's the wrong direction for optometry, if it wants to advance. The right move would be more schools with smaller class sizes to maximize the per student clinical pathology exposure. See DILLIGAF's post in the New Optometry Curriculum thread.

 

[webby82]

I'd argue that's the wrong direction for optometry, if it wants to advance. The right move would be more schools with smaller class sizes to maximize the per student clinical pathology exposure. See DILLIGAF's post in the New Optometry Curriculum thread.

Perhaps you are correct but I think that this is more of an industry issue. Small independent schools will have to merge or risk going out of business.

The optometry industry is not progressive and it does not have member organizations that support growth. Those organizations support the status quo and keeping their practices as robust as possible. They do not support more people in the profession.

 

[Visionary]

Perhaps you are correct but I think that this is more of an industry issue. Small independent schools will have to merge or risk going out of business.

The optometry industry is not progressive and it does not have member organizations that support growth. Those organizations support the status quo and keeping their practices as robust as possible. They do not support more people in the profession.

As an outsider, of course, I still have to disagree. If Oklahoma is able to have a successful school with class sizes of 28, it should be possible for any school. The issue is running it as a school and not a for-profit business enterprise, which from some of the posters in-the-know on this forum seems to be the model of a lot of the schools. As for your last statement, I wasn't suggesting producing more overall graduates. Rather, there should be more schools, each of which graduate fewer, more clinically experienced students. I think that would be good for optometry, as well as for patient care.

 

[mclem222]

I disagree. I think there should be more optometry schools. With the demand for aging patients and increasing population of the US how can we say the need goes down. The arguments we made for expanding priveliges are that there aren't enough eye providers with certain skill sets in certain areas of the US. If we are not careful, the opticians will make the same argument to perform refractions and then advance to take over our position. I am not saying create 100 schools but I think we need to take a hard look at what population supports one of us, 10K, 20K. Then just simply divide the us population by that. If the current number of ODs is less then we need more. If the number of ODs is more then we should keep things the same or contract the class sizes. Makes sense?

 

[Visionary]

I disagree. I think there should be more optometry schools. With the demand for aging patients and increasing population of the US how can we say the need goes down. The arguments we made for expanding priveliges are that there aren't enough eye providers with certain skill sets in certain areas of the US. If we are not careful, the opticians will make the same argument to perform refractions and then advance to take over our position. I am not saying create 100 schools but I think we need to take a hard look at what population supports one of us, 10K, 20K. Then just simply divide the us population by that. If the current number of ODs is less then we need more. If the number of ODs is more then we should keep things the same or contract the class sizes. Makes sense?

See, you haters, this can't be socal2014. Where's the "optometrist oversupply" rant? 😀

 

[nc2tarheels]

I disagree. I think there should be more optometry schools. With the demand for aging patients and increasing population of the US how can we say the need goes down. The arguments we made for expanding priveliges are that there aren't enough eye providers with certain skill sets in certain areas of the US. If we are not careful, the opticians will make the same argument to perform refractions and then advance to take over our position. I am not saying create 100 schools but I think we need to take a hard look at what population supports one of us, 10K, 20K. Then just simply divide the us population by that. If the current number of ODs is less then we need more. If the number of ODs is more then we should keep things the same or contract the class sizes. Makes sense?

wow

 

[IndianaOD]

I think 1 OD to around 12,000 population may be about right. The old figure always batted around was 10,000 but ODs now see more patients for less money.

So in the USA approx 300 million people. I'm guessing around 40.000 ODs give or take a few.

300 million divided by 40,000 = 7500 per OD.

But wait that doesn't even consider 15,000 to 20,000 OMDs.

Just one of numerous examples of oversupply.

 

[ohiostateboy]

See, you haters, this can't be socal2014. Where's the "optometrist oversupply" rant?

see: dissociative identity disorder 😡😱😀😉🙂

 

[DILLIGAF]

"I think 1 OD to around 12,000 population may be about right. The old figure always batted around was 10,000 but ODs now see more patients for less money.

So in the USA approx 300 million people. I'm guessing around 40.000 ODs give or take a few.

300 million divided by 40,000 = 7500 per OD.

But wait that doesn't even consider 15,000 to 20,000 OMDs. "

There are 34,800 OD's in the US, and 24,000 OMD's....both according to the Bureau of Labor. Given this fact, there is more argument to be made for OMD oversupply than for us.

With this said, there most certainly IS an oversupply of OD's right now, in 2011, with the current economy and demographics. A main driver of this is that a large number of the HUGE age cohort of the baby boomers, as well as the mid-80's population bump, are currently BOTH in the job market. With the economy having taken a beating for the last 3 years, there have been far fewer people retiring across the economy, as "safe" retirement funds were some of the hardest hit by the recession. (Could only buy AAA rated CDO's, which just happened to be leveraged into housing overwhelmingly) With this fact, along with a lot of the mid-80's boomers hitting the job market recently, has created a labor gap that has been exacerbated by the lack of retirees.

In the next 10 years, the number of OD's in the US is expected to grow by 8400, an increase of 22%. Alongside this, the US population is expected to grow by 30%....add to this the fiscal situation that most states are in will increasingly lead to looking for more savings, especially in healthcare. This is a BIG part of the leverage that the AOA and state OD associations have successfully been using to get laws passed, and to sway managed care more for optometry. Seeing as this is largely in the dump right now for us (managed care I mean), almost any improvement would be huge financially for optometry.

So I guess that my point is that oversupply is a BIG problem in the current economy and demographics, but that I believe it will improve in the next decade or so. I could be wrong, and will probably be long out of the business by the time I am proven right or wrong. Just my opinion....thanks.

 

[Commando303]

I disagree. I think there should be more optometry schools. With the demand for aging patients and increasing population of the US how can we say the need goes down. The arguments we made for expanding priveliges are that there aren't enough eye providers with certain skill sets in certain areas of the US. If we are not careful, the opticians will make the same argument to perform refractions and then advance to take over our position. I am not saying create 100 schools but I think we need to take a hard look at what population supports one of us, 10K, 20K. Then just simply divide the us population by that. If the current number of ODs is less then we need more. If the number of ODs is more then we should keep things the same or contract the class sizes. Makes sense?

How many more schools of optometry do you feel there should be? Fewer than twenty have filled the nation's pool of O.D.s for as long as the degree has existed in the United States, and, since the beginning of the 21st century to just ~2015, it seems the number will increase by at least 30% from what it was (i.e., seventeen) in 1999.

I'm not suggesting the need for optometrists is decreasing, but simply that it might not be increasing nearly so fast as some persons (and, more commonly, many schools) claim: Yes, people are living longer, and yes, older persons generally have more (and more severe) health problems than do younger ones (the eyes do fall into that arena); but, does this really increase demand by so much? Much of the ocular care older persons need will have to be delivered by ophthalmology, anyway — will the "co-management" burden on optometry, then, call for such an increase in practicing O.D.s? One final point (perhaps slightly convoluted): as persons are living longer, so, too, are optometrists: unlike many, optometry is a profession in which practitioners can successfully putter around into a rather ripe age.

I hate to see people rip on new institutions simply because they feel threatened and annoyed by change, and I'm not even suggesting, here, the quality of optometric education will diminish directly as a result of more schools' opening. I do, however, question whether there truly is need in the nation for so many more O.D.s, and I earnestly wonder if casually throwing so many more fish into the pond will not do damage to those already in it as well as to those looking to jump in.

 

[200UL]

I agree with visionary. Expanding class sizes dilutes clinical experiences. Therefore, more schools with fewer spots at each would be the way to go but the $ issues will always limit this.

Clinical experiences and training in procedures with actual patients is what optometry schools are lacking now. One seasoned optometrist recently posted on here that the average optometry student, graduates with seeing less than 1000 patients at the time of graduation - for this reason he will never hire a new graduate unless they have completed a residency. The average OMD will see 1000 patients in the first 4 months of residency.

I have always believe, providing medical / eye care requires more than listening to a lecture. If the primary goal is to provide jobs for graduates - number of schools / number of spots does matter. If the primary goal is to create well trained doctors who are able to treat more conditions / more patients (the things the bills in KY and OK grant), the focus should be on improving the clinical training of the current optometric training programs – settling for “1000 patient” encounters is not the way to go – unless every one of your graduates go on for residency.

 

[mclem222]

there may be 30-40K ODs and 25-30K MDs but do they practice full time? A lot of female ODs and some female OMDs practice work part time. The number of practicing people is less. I think also you can't count OMDs and ODs together for demand. There are tons of patients I see who wouldnt consider going to a OMDs office because it is more convenient to come to my office in a walk in basis etc... They have a small refractive error and that is it. However, my brother gets sent patients from other MDs for evals and they wouldnt consider sending them to an OD. Those represent 70-80% of his practice. Not that many people who just want an eye check etc..So he is competing with me with only 20-30% of the practice and the types of patients that see him for refractions are other MDs, very type A professionals who want to know all his credentials etc.. They are more concerned that he didn't do his residency at Wills Eye Hospital rather than Temple etc.. They aren't even considering coming to my office. The point is that the pool is a little different for ODs and OMDs so the number doesn't reflect well. According to the ophthalmologists I know, you need about 25K people to support 1 OMD, so the number is different I think. For some specialties it can be even more, like neuroophthalmology which is supposedly 1 million to 1. Bottom line I dont think they should be evenly counted in the pool. All those patients that go to corporate places generally are not interested in coming to an OMD and to quote one of my senior partners when I was just starting "You'll never hear this from an another OD publicly but when something is really wrong, most patients feel that they need to see an MD". The type of patients between the two have crossover to a certain extent but they tend to be largely different. I don't think the pool is the same bottom line. There will be some people here who will say "I see tons of people with pathology etc.. and that is my practice but I think honestly they are a minority of the group, like OMDs who are doing refractions all day and giving glasses.

 

[IndianaOD]

there may be 30-40K ODs and 25-30K MDs but do they practice full time? A lot of female ODs and some female OMDs practice work part time. The number of practicing people is less. I think also you can't count OMDs and ODs together for demand. There are tons of patients I see who wouldnt consider going to a OMDs office because it is more convenient to come to my office in a walk in basis etc... They have a small refractive error and that is it. However, my brother gets sent patients from other MDs for evals and they wouldnt consider sending them to an OD. Those represent 70-80% of his practice. Not that many people who just want an eye check etc..So he is competing with me with only 20-30% of the practice and the types of patients that see him for refractions are other MDs, very type A professionals who want to know all his credentials etc.. They are more concerned that he didn't do his residency at Wills Eye Hospital rather than Temple etc.. They aren't even considering coming to my office. The point is that the pool is a little different for ODs and OMDs so the number doesn't reflect well. According to the ophthalmologists I know, you need about 25K people to support 1 OMD, so the number is different I think. For some specialties it can be even more, like neuroophthalmology which is supposedly 1 million to 1. Bottom line I dont think they should be evenly counted in the pool. All those patients that go to corporate places generally are not interested in coming to an OMD and to quote one of my senior partners when I was just starting "You'll never hear this from an another OD publicly but when something is really wrong, most patients feel that they need to see an MD". The type of patients between the two have crossover to a certain extent but they tend to be largely different. I don't think the pool is the same bottom line. There will be some people here who will say "I see tons of people with pathology etc.. and that is my practice but I think honestly they are a minority of the group, like OMDs who are doing refractions all day and giving glasses.

I disagree with your statement that a large majority of patients feel like they need to "see an MD" if they think something is really wrong. It depends on what type of office you have and the image you project. I see a lot patients who have been going to walmart etc for eye exams for years and once they think something is wrong they come see me. Very, very few of those cases need surgery (OMD) and I think it wise that patients who even need surgery see an OD because they can recommend the best OMD for the case. For example if a patient with a retinal tear goes to our local OMD group (all generalists) they will get retinal surgery from a general OMD whereas I will send them to a retinal sub specialist.

Our practice is in a medical office building and we have most of the latest equipment. We also charge appropriately for exams and are on all the local medical insurance panels. I do have a fair number of "credentials" but I think image is a big part of it. It is this image problem that commercial optometry "spin and grin" practices support.

 

[mclem222]

This may also reflect where we both practice...I am in Philadelphia...in Indiana things may be different. The demographics of the population in the locations could be very well different. For example in philly there are no general OMDs doing retinal surgery or lasers for tears. It may be different in your home state. My opinion may be reflection of my location. If you are from Indianapolis (I am assuming that is the biggest city in indiana) that is going to be markedly different from Philadelphia. I have classmates who practice in rural washington state who pretty much are the only eye provider in the area. Also their patients dont question their credenitals etc.. as much. I have patients that have asked me if I did a residency as an OD and why I decided not to go for the MD. My brother who practices in the city have had patients refuse to see him because he did a fellowship in cornea at Mt Sinai and not Columbia. He did his internship in Iowa and there he said he could have told a patient I am going to do brain surgery on you and the patient prescribed much more to the paternalistic model of medicine and never question the doctor, what his training was etc... However in residency in Philly, cataract patients would not only ask if he was a resident or attending but if he was a resident or fellow (they knew to ask the difference) Point is...our experiences may be different because of location and patient demographics.... I don't think it is just types of practice etc...In Indiana you may very well be able to have a practice such as that by "marketing" etc.. and location but I bet if you set up the same thing in park avenue NY you would not get the same result. It just will take time for people's minds to change about optometry. Our profession has changed so much in a short period of time. My old partner's father was an optometrist that was a jeweler. His experience and his son's are going to be different than your or mine. No? Also that wasn't my opinion but the opinion of the senior partner in the practice..

Final comment: You also mentioned that it is your opinion that a patient who needs surgery see an OD because we can recommend the best surgeon. I disagree completely with that statement because there are people I refer to and it isn't necessarily who is the "Best" surgeon. It is because I like them, patients like them, and their outcomes are good. There may be an OMD in my area who is the best cataract surgeon in the world. If he never took the time to meet me or talk to me, I don't know him and won't send him patients. Also my friends who practice in other states like Colorado and NEw Jersey send everything to an optometry owned surgical practice called OMNI. They don't do it because those are the best surgeons or nicest docs. It is politically beneficial. Sometimes it is 2 hours away for the patient when there is a local OMD in the area who is just as good if not better. Now I don't blame them becasue I do the same thing. OMDS who are politically against me, I tend not to send things to but it isn't personal.It;s business. But I call it as I see it and don't pretend that I have some special knowledge of all the skills of the surgeons in my area and can say which is the best one. (who also to be the ones who visit me, are my friends, are politically supportive of optometry). I don't claim that the surgeon I refer to is the best, I say they are good, are nice and I think the patient would be happy there. Now in Indiana where you practice there may be only a few OMDs but in Philly there are tons so again the experience might be different.

 

[KHE]

I disagree. I think there should be more optometry schools. With the demand for aging patients and increasing population of the US how can we say the need goes down. The arguments we made for expanding priveliges are that there aren't enough eye providers with certain skill sets in certain areas of the US. If we are not careful, the opticians will make the same argument to perform refractions and then advance to take over our position. I am not saying create 100 schools but I think we need to take a hard look at what population supports one of us, 10K, 20K. Then just simply divide the us population by that. If the current number of ODs is less then we need more. If the number of ODs is more then we should keep things the same or contract the class sizes. Makes sense?

I simply can't agree with that.

The notion that aging patients are going to suddenly cause a sharp rise in demand for optometric services is, in my opinion a complete non-starter.

All of these aging patients have been presbyopic for 20 years. They have been in the optometric pipeline for years. If anything, I think demand for optometric services would go relatively DOWN as they reach absolute presbyopia. Yes, they'll develop cataracts and macular degeneration but ODs don't treat those things. So at best, we might scrounge up a couple of office visits out of them because while there might be an overall increase in the demand for eye care in general, what evidence do we have that it will be optometrists who are the ones to meet this demand? You yourself said in another posting that many patients will only see your brother because "he's an MD" You also said that your mentor told you that many patients feel they need to see an MD if there is "something wrong" so where in your mind is this increase in demand for optometric services from an aging population coming from?

I also disagree with the notion of "underserved areas." Certainly there are areas that are over saturated like most large urban metros but can anyone point to a single area of the country where one can not get a routine eye exam from an optometrist within two days and within an hour's drive?

I read over the weekend a review of optometry article in which a potential new school in Boston was discussed. The "dean" or whatever this woman's title who was the lead on this thing mentioned many times that they planned to target underserved areas. Again...I would ask where exactly are these underserved areas and how are you going to ensure that any students you admit will actually practice in this theoretically underserved areas?

Technology and health care economics really has allowed the same number of ODs to see a larger number of patients in the same amount of time. Gone are the days of the kindly old eye doctor seeing 8 patients a day and doing a 21 point OEP exam on every patient for an hour before selling you a $500 pair of glasses that he crimped by hand in the back.

The number of schools should be drastically cut. Certainly not expanded.