Scott A. Edmonds, OD, FAAO, focuses his blog on the role of the optometrist in health care reform – moving from primary eye care to primary health care. He is the chief medical officer of MARCH Vision Care, the co-director of the Low Vision/Contact Lens Service at Wills Eye Institute in Philadelphia and a member of the Primary Care Optometry News Editorial Board. 

Disclosure: Edmonds is a consultant for March Vision.

BLOG: Where is the resistance to health care reform? – Reprise

On Feb. 5, 2016, I posted, “Where is the resistance to health care reform? Now, here at the end of the summer of 2019, I thought this would be a good time to check in and see how we are doing. As we start this presidential election cycle, health care reform seems to be at the top of everyone’s list. Voters are interested, and candidates want to talk about it, so let us take a closer look.

Are optometrists more interested in health care reform? There seems to be a general trend forward. Based on the review of medical charts that my team provides for health plans in 35 states, I see more optometrists measuring vital signs as part of the eye exam and more and more electronic medical records. I have also found an increase in membership in the Ocular Wellness and Nutrition Society and I know that I enjoy their Weekly Wellness Spotlight. Optometrists are reducing their resistance to health care reform.

Are physicians more interested in health care reform? Not that I can see from a review of their literature. According to the website of the American Medical Association (AMA), physician burnout is their number one health concern. According to Sara Berg, senior news writer for the AMA, in an article published in June, physicians are not embracing prevention or wellness. In her piece she notes that even with the AMA’s own Diabetes Prevention Guide, shown to be effective in patients at risk for diabetes, only 4.2% of their physicians made a referral to the program for those at risk and interested. I must conclude from this evidence that physicians remain resistant to health care reform.

The health insurance industry seems to be moving in the right direction with a shift to more HMO products and less traditional insurance. Health insurance, by definition, does not cover prevention and wellness programs, as their payments are based on disease or injury. HMOs, however, are designed to contain cost by aggressive prevention and wellness programs and some are even moving to include optometry in their quest to improve health.

It is no surprise that the pharmaceutical industry has no interest in health care reform. Of the 26 new drugs approved in 2019, zero are related to prevention or wellness. Although there are plenty of products available to assist providers with wellness strategies, these are not coming from the pharmaceutical industry.

Lastly, American patients seem to be taking a more positive look at health and wellness issues. In spite of the controversy, the Philadelphia surgary beverage tax is still in play. We have also added bicycle lanes on many of our main streets. The CDC, in an April 22, 2019, press release reported that half the workplaces in American now offer health and wellness programs. I note that many of my friends and patients are wearing fitness trackers, working on their daily step count and watching what they eat. These are good sign that patients are now more receptive to health and wellness programs and are more interested in a proactive stance on health care, which is essential to meaningful reform.

Although this review is mixed, the overall trend is positive on a better acceptance to health care reform in America. Optometry’s role in particular has improved, so perhaps all of my drum beating has not been in vain. This election cycle will be critical. Read, listen and use your vote and your influence wisely.


Berg S. Diabetes prevention message not getting through? What you can do. AMA. Posted June 24, 2019. Accessed September 11, 2019.

CDC. Half of workplaces offer health/wellness programs. Posted April 22, 2019. Accessed September 11, 2019.