The 19th century British essayist William Hazlitt once stated,
When a thing ceases to be a subject of controversy, it ceases to be a
subject of interest.
No truer words could have been uttered, and, to this day, we find Mr.
Hazlitts quote rings true.
Optometry, of course, is no stranger to controversy. We debate
sometimes ad nauseum which drug, contact lens or spectacle lens is best
for our patients. We also debate which diagnostic instruments are indicated,
how often a patient should be seen and how frequently one needs to replace his
or her contact lenses.
Occasionally, we spar with those outside our profession on issues
ranging from scope of practice to reimbursement levels for our services.
However, arguably, no controversy is more heated or has further reaching
implications than that of optometric manpower.
Optometry has long perceived itself as the primary eye care
profession. It has done so for good reason, as twice as many Americans surveyed
by the American Optometric Association said they would see an optometrist over
an ophthalmologist for their eye care (AOA 2008 Consumer Survey). So, it stands
to reason we must be sure we have adequate manpower to meet the publics
In addition, with aging baby boomers defining our countrys
demographics, it is obvious the demand for eye care will continue to escalate
over the next few decades. The question is whether optometry is adequately
prepared to meet these demands.
On one hand, increasing optometric manpower can be adequately achieved
by simply training more optometrists. This trend is already well under way with
the opening of three new optometry schools over the past 5 years and two
more programs in development. In fact, optometry school enrollment
(collectively) is up more than 10% compared to 2006.
On the other hand, it can be argued that these manpower needs can be
effectively addressed by increasing efficiency among existing optometrists.
Certainly, technology and delegation continue to positively impact our ability
to provide exceptional care in an efficient fashion.
So, the question and controversy remains. Do we need more
optometrists or should we strive for greater efficiencies within our current
While I do not foresee a resolution to this controversy any time soon, I
do see a consensus in one respect. It is the consensus that whether we increase
optometric numbers or efficiencies, we must insist on quality. In other words,
if we increase the number of schools and graduates, we must commensurately
increase the number of viable applicants. Merely accepting candidates
especially those previously considered unacceptable in the name of
filling seats is not an appropriate solution.
Conversely, if we are addressing manpower needs through increased
efficiencies, existing optometrists must embrace newer technologies and the
concept of delegation. Anything less and the results are sure to be equally
In short, if we are to preserve optometrys heritage and reputation
and provide our patients the care they deserve, quality is imperative. For
this, there is no controversy.