Things are never quite as bad – or as good – as they first seem.
Lately, I have heard a great number of what I call "gloom and doom" statements about optometry. These statements are often made by vision plan companies, industry publications, optical vendors, eye care consultants or optometrists in online forums. There is usually a certain amount of sensationalism associated with the statement. In some cases there may be a hidden agenda or profit motive behind the revelation. Usually there is a basic statement that is true followed by some assumptions or conclusions, which sound plausible, but are not always based on fact.
I think optometrists have enough challenges facing them every day and we would do better if we fought the battles that are here and now. Don't be distracted and waste energy on things that may or may not happen or are simply beyond our control.
It seems to me that optometrists are masters at worrying about what might happen, even though a high percentage of the assumptions are incorrect or never actually come true. I have seen many threats and scares to the optical industry in my 30+ year career. Some of these turned out to be no big deal and in other cases, optometrists found a way to manage the issue. The profession of optometry is still doing very well and I believe there will be even more demand for our services in the future.
As examples, here are a few gloom and doom statements I've heard recently that have some ODs in private practice very worried. I'll place the statement in italics and my comments in regular print.
VSP recently started requiring providers to accept the Choice plan, which is regarded as a low cost plan. This will lead to lower reimbursements. My practice decided to accept all the VSP plans long ago and the Choice plan pays less on some items but allows us to collect more on others. The Choice plan is calculated differently than the Signature plan, but our practice profitability is about the same with both. I don't see this move as a sinister plot to hurt optometry.
EyeMed is vertically integrated with retail optical stores and they are steering patients away from private practice optometry. I'll admit that I don't know their inner corporate strategies, but I've been an EyeMed provider for many years and have never experienced this. If they have done some marketing to benefit their retail outlets, it has not made any difference to my practice. It seems to me that for EyeMed to be successful as a vision plan, it needs providers in all categories. EyeMed knows that many patients prefer private practice ODs and there is often strong loyalty to one's eye doctor. I think EyeMed is best served by a very broad provider base. I don't think EyeMed is out to hurt private practice optometry.
Online optical sales are growing by leaps and bounds and private practice ODs will soon lose that segment of business. I think we all understand that e-commerce is changing buying habits of products in all industries and categories, but I don't think ODs realize that it is happening relatively slowly for prescription glasses. The Vision Council conducts the only large-scale study I know of for online optical sales each year. Here is the percentage of prescription eyeglasses sold online to U.S. consumers for the past several years: 1.9% in 2008, 2.9% in 2009, 2.8% in 2010, 2.4% in 2011. I have not seen 2012 data yet and I would not be surprised if we see a noticeable jump at some point, but if we look at the facts, the segment is small and growing slowly if at all. We will have time to adapt and find new profit centers in our practices. There will likely be a leveling off of online sales at some point in the future. Patients like to try on glasses in person and they value the help of a trained optical professional.
Specsavers is an extremely successful chain of discount optical stores in the United Kingdom and Australiaand they may be coming to the U.S. They are capable of putting independent optometry out of business. A new concept in eye care that is extremely well-managed and well-financed could certainly start here, but I would not underestimate the power of independent ODs. We have competed with many optical discount stores for over 100 years and the trust between doctor and patient has remained quite strong.
Obamacare will cause a huge decrease in fees being paid by health insurance plans and Medicare. We are just starting to see some of the effects of healthcare reform but we won't really know the true impact for a few years. Medicare fees have been maintained for 2013. We may see some reimbursements decrease in the future, but optometry may benefit from the increase in numbers of patients. Unlike many medical specialties, optometrists generally need more patient demand. ODs may also find they are allowed access to health insurance panels they were previously excluded from.
Wellpoint (Blue Cross/Blue Shield) recently bought 1-800 Contacts and they will market online contact lenses to their members, cutting out the OD. And now Wal-Mart is launching its own brand of contacts. I'm sure 1-800 will market contact lens products to the best target groups it can, but we have competed with 1-800 and Wal-Mart quite well for many years and I don't see that changing. Private practice optometrists have a very loyal base of patients who really prefer to do business with them.
I recently watched a movie titled "The Best Exotic Marigold Hotel" and I loved the optimistic quote by the main character, Sonny, which seems quite appropriate for this gloom and doom topic. He said, "Everything will be all right in the end... and if it's not all right, then it is not yet the end."
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.