July 15, 2009
Regina Benjamin, M.D., M.B.A.
United States Surgeon General (designate)

Dear Dr. Benjamin:

Please allow me to extend my most sincere congratulation on your nomination as Surgeon General. Given your credentials, unique experience and dedication, you are ideally suited for this challenging position at a critical time for health care in our nation.

I am sure you are aware of the numerous health care issues facing inner-city and rural America. One issue that I find particularly troubling is the unmet need for programs to address preventable threats to visual health. The Department of Health and Human Services Healthy People Program identified the most significant threats to visual health and established goals to reduce those threats. The program addresses visual impairment due to eye disease/conditions including glaucoma, diabetic eye disease, cataract, amblyopia and refractive error and recommends: regular eye examinations for children and adults, vision screening for preschool children, eye injury prevention, and low vision examination.

These visual health goals can only be achieved when all Americans and, particularly those in rural and inner-city areas, have access to eye care services. Only about 20 to 30 percent of all federally qualified health centers provide eye care services, despite the growing disparities that exist for rural and inner-city Americans.

Efforts must be made to attract more optometrists to rural and inner-city areas through financial incentives such as student loan forgiveness and equipment purchasing grants and loans. Inclusion of optometry in the National Health Service Corps (NHSC) is essential to the placement of optometrists in these areas. I was most interested when you proudly spoke of your experience in the NHSC during your nomination speech and how it shaped your career path.

Federal and state governments should also encourage visual health education, describing the benefits of regular eye examinations for adults and children, including vision screening for preschool children and eye injury prevention. These efforts should be provided through culturally sensitive and appropriate materials and venues.

Optometry’s first program to collaborate with community health centers to improve access to inner-city Americans was developed in Boston by the New England College of Optometry in the late 1960’s, in cooperation with three community health centers. Today, the program has grown to include 14 health centers and 30 other affiliations and inner-city programs. It was also the first collaborative model of care between optometry and ophthalmology in the Nation. This community based program is now managed by the College’s subsidiary, the New England Eye Institute, and has evolved into a national model demonstrating the compatibility of a commitment to community eye care and clinical education. While few inner-city and rural health centers have eye care services, nearly all Boston health centers provide these services. Once you are sworn in as the next United States Surgeon General, you may want to review this highly effective model for possible application to other parts of our country.

Thank you for willingness to take on the challenge of Surgeon General and again congratulations.

Sincerely,

Charles F. Mullen, O.D.
Member, Board of Trustees
New England College of Optometry

Now is the Time for Federal Financing of Optometric Clinical Training
Optometry has been included in Medicare since 1987 and currently provides nearly $900 million in services annually to Medicare beneficiaries. However, optometry is excluded from the Graduate Medical Education (GME) program, the educational support component of Medicare. With the aging population and the projections for rising numbers of Medicare beneficiaries, optometric clinical teaching facilities will be providing significantly more care to to the elderly and disabled. With increasing clinical training requirements and training costs, more than ever, there is a need for federal support for optometric clinical training. The inclusion of optometry in GME addresses: the need for workforce development (supply), the growth of the population demand for eye care services and increasing clinical training requirements and costs. All are consistent with current financing policies of Medicare which are intended to anticipate and address these issues. The Social Security Act needs to be amended to include optometry in the GME program of Medicare.

Include Optometrists in the National Health Service Corps (NHSC)
Visual health is recognized by HHS as a critical unmet need, particularly in rural and inner-city areas. Only 20% of federally qualified health centers provide eye care services, despite the growing disparities that exist for rural and inner-city Americans. President Obama is requested to address the barriers to improving access to eye care services. Optometrists are reluctant to practice in rural and inner-city areas because of high levels of graduate indebtedness combined with high overhead costs of providing optometric care. Efforts must be made to attract more optometrists to rural and inner-city areas through financial incentives such as student loan forgiveness, equipment purchasing grants and loans, and support to the health centers in establishing eye care clinics. In addressing shortage area needs, inclusion of optometrists in the National Health Service Corps is essential to attract optometrists to these areas. HRSA and HHS need to amend their policies and regulations to include optometrists in the NHSC and to provide funding for equipment and facilities costs.

Visual Health as a Critical Unmet Need in Rural and Inner-City Areas
Visual health is a critical unmet need, particularly in rural and inner-city America. HHS’ Healthy People program identified the most significant threats to visual health and established goals to reduce those threats. However, these goals can only be achieved when all Americans and, particularly those in rural and inner-city areas, have access to eye care services. Only about 20% of federally qualified community health centers provide eye care services, despite the growing disparities that exist for rural and inner-city Americans. President Obama is asked to address the barriers to improving access to eye care services. Efforts must be made to attract more optometrists to rural and inner-city areas. Including optometrists in the National Health Service Corps, funding for optometric training through the GME program and support to the health centers for the provision of patient services in rural and inner-city areas are potential means to address access to eye care services.

Combat Eye Trauma and Vision Impairment Caused by TBI
Serious combat eye trauma is now the third most common injury only behind PTSD and Traumatic Brain Injuries (TBI). Of the service members with TBI, many have post traumatic visual impairment as well. An overall plan needs to be developed and implemented that ensures a seamless transition from DOD facilities to the VA for those with eye trauma and visual impairment caused by TBI. Initial care must be timely and comprehensive and follow-up care monitored and assured for all servicemen and women with eye trauma and vision impairment. All too often well-developed plans do not have accompanying evaluation processes and mechanisms to take corrective action once the plan is implemented. The effectiveness of the plan needs to be evaluated by a continuum of outcome measures both in DOD and the VA. Identified areas of concern need to be promptly and decisively addressed by a single office vested with the power to take corrective action whether problems exist in DOD or VA.

Medicare Policy to Permit Students to Contribute to Billable Services
Medical, dental, optometric and podiatric students are an intelligent and well trained component of the health care workforce. However, current Medicare policy does not permit students to perform services that can be billed to Medicare. In order to more effectively utilize this enormous workforce, Medicare policy should be changed to permit students to participate in the Medicare program. This is particularly important in under served areas where students often receive their clinical training.

Interview commissioned by the Massachusetts League of Community Health Centers and conducted by James Hooley.

See also:

• The New England College of Optometry Clinical System
• Affiliation Between Hahnemann University and the Pennsylvania College of Optometry
• Illinois College of Optometry and the University of Chicago Affiliation Agreement
• Charles F. Mullen’s Speech at the Kennedy Library
• Distinct and Separate Legal Structures for Optometric Clinical Programs

Honored guests.

This morning, I would like to share with you the beginnings of optometry’s first program to collaborate with community health centers to improve access to eye and vision care services and enrich optometric clinical training.

I will attempt in my brief remarks to relate the common elements of the initial program to the new corporate structure and community governance model of the New England Eye Institute. I plan to outline the challenges which, I believe, still lie ahead for the new organization and finally, with your permission, offer a few observations or suggestions from my years of experience in interprofessional cooperation.

In the late 60′s and the early 70′s, the New England College of Optometry decided to expand and enrich the clinical training environments to which its students had access.

We knew that optometry students would benefit from health care environments in which the optometrist was one of many health care professionals contributing to the care of the patient.

Inner-city demographic data suggested that students would have the opportunity to participate in the care of patients with serious eye and vision problems unlike the university students they typically examined at the College’s Kenmore Square Clinic.

We wanted students to learn in a quality health care environment and not a teaching clinic as was customary at that time. Quality clinical training could only be achieved in a quality health care setting.

Coincident with our educational mission and not at all incompatible with it was a commitment to providing eye and vision care services to inner-city residents who were unable to meet this health care need in their own communities.

We concluded that the most promising scheme for fulfilling both our educational and community service objectives was to form an innovative network of affiliations with existing health care centers. Innovation was an important element in the development of the clinical network as it is today for the New England Eye Institute.

As we began to develop the program, any illusions we may have had about the ease of executing our new strategy were quickly dispelled. We learned a lot about skills we thought had nothing to do with eye care or optometric education: about convincing skeptics, compromising, introducing safeguards, planning, and negotiating.

In the first place, there was a reluctance on the part of health center administrators to permit students to participate in their programs.

Historically, the health center community was disenchanted with receiving its health care in the emergency rooms of large teaching hospitals and our proposed program, they thought, was precisely what they were seeking to escape.

Our second problem revolved around the reluctance of medical staffs at some health centers to work directly with optometrists, since the physicians had little experience working with us.

It was necessary to convince the medical staff at a very fundamental level of the ability of optometrists to function in and contribute to an interdisciplinary environment.

We also encountered considerable political pressure from the ophthalmological society which opposed cooperation between optometry and ophthalmology in the new eye and vision care model to be developed in the community health centers.

I am always reluctant to single out individuals for fear of omissions, but I would be remiss without citing the bold leadership of a few who were responsible for the success of the 70′s community eye care initiatives: Health Center administrators, Jim Hooley, Dorchester House, Mel Scovell and Tris Blake of the South End Community Health Center and Bob Morgan of the Dimock Community Health Center in Roxbury. Bill Baldwin, President of the New England College of Optometry for granting me the opportunity to participate in the development of the clinical network.

The optometrists who were willing to pioneer a new approach to interprofessional collaboration: faculty from the New England College of Optometry–Ralph Levoy, Jerry Selvin, Matt Garston, Jeff and Neal Nyman and the young Barry Barresi.

And, three courageous ophthalmologists, David Miller from Beth Israel Hospital and Harvard and Marc Richman and Andre Quamina from Boston University, who believed in the new model and were committed to providing comprehensive eye and vision care to the community health center clients. They withstood the persistent political pressure and the new optometric-ophthalmological interactional model was implemented at the South End and Dimock Community Health Centers and the Dorchester House for the first time in the United States. Bold leadership was as important then as it is now.

This eye care protocol has now evolved throughout the country, more recently into a comprehensive affiliation among the Illinois College of Optometry, the University of Chicago Medical School and its University Hospital System for the provision of ophthalmic care, medical and optometric education and research.

And, the fourth problem had to do with the antagonism our new eye care model aroused among private optometric practitioners, many of whom were our own alumni and friends. They felt that we were intruding into an area that is rightfully theirs.

I was pleased to learn that this issue has been largely resolved through the leadership of the Massachusetts Society of Optometrists.

The common element that emerged throughout the development process was the importance of effective collaboration among all of the constituencies. Community health center boards and community advocacy groups at first were skeptical, then later became strong supporters of the effort. Their support was critical to the success of the program.

The College and health center collaboration soon began to develop into a successful story of mutual respect and aligned missions. These were the key ingredients in improving community access to eye and vision care services in the 70′s, as they are today.

After successfully negotiating a mutually acceptable agreement with the Dorchester House Multi-Service Center and after strengthening our affiliation with the U.S. Public Health Services Hospital in Brighton, we went on to develop additional relationships in Boston. The South End Community Health Center, Dimock Community Health Center, Eye Research Unit of the Joslin Diabetic Foundation, the Kennedy Hospital in Brighton, Cotting School for Handicapped Children, Department of Veterans Affairs Outpatient Clinic, and the Gundersen Eye Clinic at Boston University.

Other institutions, upon hearing of the success of our collaboration and new eye care model, asked for assistance in establishing eye and vision services. These included: the Massachusetts Institute of Technology, Harvard Community Health Plan and the University of Massachusetts at Amherst.

All of these organizations were willing then to take the risks of new programs and innovative approaches to community eye and vision care as the New England Eye Institute member organizations are willing to take the risks of new programs and innovative approaches in this exciting new venture.

In 1976, upon leaving for Philadelphia, I wrote in an article later published in the Journal of the American Optometric Association on my assessment of the initial phase of the program.

We have reason to believe that we have achieved most of our clinical development goals to a greater degree than we ever could have anticipated.

Over 45,000 eye visits were provided to community residents in 1976. Many community residents had never before received eye or vision care.

Our students are seeing more challenging patients than their predecessors saw.

They have learned from and worked effectively with ophthalmologists and with professionals in pediatrics, internal medicine, nursing, psychology, and low vision.

Faculty and students were successful in convincing many that optometrists can make an important contribution in an interdisciplinary health care setting.

A very workable eye care protocol involving technicians, optometrists and ophthalmologists was developed and implemented.

Our graduates have very different professional aspirations as a result of their community health center experience. Some went on to work in community health centers and some have become deeply involved with the whole issue of public health and some are seeking to broaden their education and assume roles in health care policy. We have a living example here today in Barry Barresi.

A new level of innovation and collaboration has been introduced in the 21st century to build on a program created in the 70′s.

A major step was taken by the New England College of Optometry by reallocating its clinical assets into a community governed organization. Even with a history of over 30 years of collaboration, much work is still needed to be done to truly transform the New England Eye Institute into a leading community services organization for Greater Boston and a model for other cities around the country. Several challenges can be identified.

Educational programs need to be expanded to include trainees not only in optometry, but also ophthalmology, medicine, nursing, and other health care professionals, such as occupational therapists, social workers, low vision and blind rehabilitation specialists.

It will not be sufficient to provide only eye and vision services, for the New England Eye Institute needs to embrace a community oriented approach to health promotion and prevention.

The new organization must be flexible and integrated to truly meet the public need. It must position the Institute to meet the needs of special populations – the homeless, the frail elderly, the home bound, the developmentally disabled, the severely visually impaired, and others.

The quality of care must be monitored and maintained with appropriate mechanisms and oversight.

And, development efforts need to be aggressive in seeking the necessary operating and capital funds to support the Institute.

Finally, I would like to conclude with a few observations based on my many experiences in interprofessional collaboration that could be applied to the New England Institute.

The key ingredients in any successful collaboration are mutual respect and aligned missions.

Innovation must be proceeded by careful planning and boldness tempered by fiscal reality.

There are few cities better positioned than Boston to achieve excellence in collaboration to meet the public need in eye and vision care services, in health professions education, and health promotion and prevention.

I urge the many collaborators in this new initiative to reflect on the approaches and successes of a few bold individuals who in the 70′s were willing to take risks of new programs and innovative approaches and apply the same persistence, commitment and risk taking to the New England Eye Institute.

Thank you for remembering me.

Dr. Charles F. Mullen
Kennedy Library, Boston, MA
May 14, 2003

A CONTINUED HISTORY OF THE ILLINOIS COLLEGE OF OPTOMETRY
1997 – 2000

PREFACE
The conclusion of the book Optometry in America (1872-1995) offered a glimpse at the Illinois College of Optometry’s bright future. In February 1995, the College received a positive accreditation review by the American Optometric Association Council on Optometric Education (COE). Also that same year, the first stage of an ambitious campus expansion was completed in the building of a new residential complex on Indiana Avenue at 33rd Street.

By March 1996, however, the school’s bright future was overshadowed by controversy. A politically motivated article appeared in a Springfield, Illinois newspaper. This news item was picked up and published by the Associated Press. These two events triggered a series of allegations and investigations that resulted in the resignation of ICO President, Dr. Boyd B. Banwell.

Upon Banwell’s departure, a management team was formed by the Board of Trustees that included: Board Chairman Dr. John E. Brandt, Chairman-Elect Dr. Albert H. Rodriguez, Jr., and Trustee Dr. Joseph Henry. The team worked to maintain the daily operations of the college and assuage the concerns of faculty, students and staff. They also worked with legal counsel to satisfy the Office of the Illinois Attorney General, the Internal Revenue Service and the College’s financiers.

A search committee, chaired by Dr. Henry, initiated the recruitment of a new college president. This team included representatives from the Board of Trustees, faculty, staff, and students. After an exhaustive search, Dr. Charles F. Mullen – who was serving as the Director of Optometry Service at the Department of Veterans Affairs in Washington, D.C. at that time – was appointed the Illinois College of Optometry’s fourth president. Taking office on November 1, 1996, the college that Dr. Mullen encountered was not quite the utopian institution which many – both inside and outside the college – believed existed.

Dr. Mullen quickly realized that although a plan had been developed for the physical expansion of the campus, a more comprehensive plan was required that encompassed improvements in ICO’s academic culture, administrative operations, financial health, institutional image, revenue streams, as well as the physical plant. Working with the President’s Advisory Council, an administrative team assembled from existing faculty and senior staff, Dr. Mullen began the Herculean task of putting the college back on course and preparing it to meet the challenges dictated by the rapid changes in the health profession’s educational requirements.

Recording the events that took place since Dr. Mullen took office, The Road to Excellence serves as a supplement to Optometry in America, chronicling – in his own words – Dr. Mullen’s first four years at Illinois College of Optometry.

INTRODUCTION
Given the Illinois College of Optometry’s historically prominent position within the field of optometric education, I was concerned when I learned of the difficulties the college was experiencing in 1996. I believed these matters had the potential to harm not only ICO, but possibly even the profession of optometry itself. When I was offered the position of president, I felt it was my responsibility to my profession to accept this role. I was confident that, in a relatively short period of time, I could redirect the college’s resources and energies, creating a culture in which all members of the ICO community were actively engaged in strengthening the institution.

We immediately made a philosophical shift from emphasis on facility development to emphasis on programmatic improvements and on the personal service provided to our students, patients and alumni.

We set out to realize a culture at ICO that was based on innovation and creativity: where personal initiative coupled with individual and collective accountability are the norm. Our goal was to develop an institution managed by fact and outcome measures, resulting in heighten productivity; a model of ethical behavior and integrity; and a culture committed to growth and improvement.

The pages that follow document our progress in realizing this new culture at ICO.

CHAPTER ONE
DEFINING EXCELLENCE
Documented in the 1996 book Optometry in America, the Illinois College of Optometry (ICO) can trace its origin to 1872. ICO, however, has only existed under its present name only since 1955: the result of the merger of the Northern Illinois College of Optometry and the Monroe College of Optometry.

Between 1955 and the present, ICO has had only four presidents: Eugene W. Strawn, O.D. (1955-71), Alfred A. Rosenbloom, O.D. (1972-82), Boyd B. Banwell, O.D. (1982-96) and now, Charles F. Mullen, O.D. (1996 – present).

The ICO Board of Trustees appointed Dr. Mullen as President on November 1, 1996. He assumed his duties on a full-time basis one month later. Mullen brought with him twenty-six years of administrative experience. He had served as Special Assistant to the President for Clinical Development (1970-76) at New England College of Optometry; as Executive Director, The Eye Institute (1976-1990) at Pennsylvania College of Optometry; and as Director of Optometry Service of Veterans Health Administration (1990-96) at the Department of Veterans Affairs, Washington, D.C.

Three years after he took office, Dr. Mullen discussed his initial impressions and objectives in a guest editorial that appeared in the Journal of the American Optometric Association (September 1999):

“Although I found there was an understandable sense of uncertainty regarding the immediate future of the College, morale was surprisingly good. It was my perception that faculty and staff were not only willing, but eager, to ‘right the ship’ and to positively engage in strengthening and improving the institution. I felt confident I could immediately assemble a capable administrative team from the existing faculty and staff.

My initial objectives included:

• Initiation of a strategic and tactical planning process.
• Enhancement of the academic culture by increasing support for faculty development, research and scholarly activity.
• Expansion of the clinical educational program by initially adding 50 community-based training sites.
• Initiation of a search for a new Dean/Vice President for Academic Affairs.
• Review and modification, as appropriate, of the administrative organization.
• Enhancement of the institutional culture, by improvement of services to students, patients, alumni and employees.
• Ensurance of the financial stability of the institution, including the enhancement of revenue streams.
• Review and modification of the master buildings and facilities program.
• Improvement of management information systems.
• Enhancement of personnel management.
• Development and implementation of public relations and fund-raising programs.
• Redirection of resources formerly allocated to an ambitious building program into programmatic improvements.

I believed that it was vital that our planning process promote open avenues of dialog with internal and external constituencies.”[1]

To achieve his objectives, Dr. Mullen formed the President’s Advisory Council (PAC) that included senior administrative management for the College and the Illinois Eye Institute (IEI),which is the school’s clinic facility. The PAC began to develop a strategic plan that defined the term “excellence” as it relates to ICO. The plan, titled Prescription for Excellence, contained five major goals, accompanying appropriate action, identification of departmental responsibility for each goal and designated completion dates.

CHAPTER TWO
PRESCRIPTION FOR EXCELLENCE
YEAR ONE
Dr. Charles Mullen understood the importance of open communication between internal and external constituencies in both the planning process and the implementation of each designated strategy in the Prescription for Excellence. As part of this process, President’s Advisory Council (PAC) members were given the opportunity to voice their opinions and concerns on a variety of subjects and to experience full responsibility for the achievement of each department’s goals. To begin their work, PAC commissioned surveys that addressed alumni and alumnae needs and concerns and student satisfaction. The compiled results had immediate impact on Dr. Mullen’s Prescription for Excellence.

In order to establish improved dialog with the community and to include them in the planning process, Dr. Mullen established a Community Advisory Board (CAB). Leaders of neighborhood organizations, school principals, clergymen, representative of community-targeted government agencies and senior ICO administrators were invited to join this team. The CAB continues to consider such issues as employment opportunities, real estate transactions, and minority student recruitment that have a direct impact on both ICO and its surrounding community.

In the Journal of the American Optometric Association (September 1999), Dr. Mullen discussed his strategic plan in great detail:

“It was now our task to channel these processes into a tangible plan of action. With input generated through countless meetings, reviews, evaluations, and re-evaluations, we created a 70-page document, the Prescription for Excellence. It contains five major goals, each with detailed, quantifiable action steps and completion dates. These action steps also identified the department responsible for their implementation. Regular monthly meetings were scheduled to evaluate our progress. These meetings – which continue today – are open to all members of the ICO community.

The Prescription for Excellence was immediately effective. The goals and directions we established continue to be important, but even more important is the process we created whereby each member of every ICO constituency has the opportunity to be meaningfully involved in the planning process…

Several important themes emerged during the planning process that have helped create a new culture at ICO. Through the planning process, five major goals were crystallized:

1. Provision of excellence in education and scholarly activity.
2. Creation and maintenance of reputation as an institution that is characterized by exceptional accountability.
3. Provision of excellence in service, as defined by our students, patients, alumni, and employees.
4. Provision of excellence in health care.
5. Achievement of recognition as a center of influence within the profession and the community.

These goals are now the basis for the performance agreements that exist between every member of senior administration and the President, as well as an agreement between the Board of Trustees and the President. These agreements are what each of us is measured by: they are the basis for budgeting and for departmental planning.”[2]

The results of that first year of implementation were noteworthy. Dr. Mullen reported those achievements to the ICO community at his first “State of the College Address” in October, 1997:

“What I have to share with you today is important to all members of the Illinois College of Optometry community. Today’s address deals with where we are at this point in time …and what our future course needs to be.

ACADEMIC CULTURE
“We have made steady progress in evaluating and improving the quality and cost effectiveness of our external clinical affiliations and our satellite facilities with a goal of achieving budget neutrality. Contracts have been renegotiated (and) as a result…we have reduced the net cost of our satellite programs by approximately $172,000. At the same time, we were achieving these reductions in costs, we have expanded our community based clinical affiliations from a handful to 75 (collaborations), providing more than 210 student rotations annually.

We have made several significant changes in ICO’s curriculum. The focus was changed to give students an overview of an optometric examination with a greater emphasis on technical skills. The optometry sequence has been modified…to complete the teaching of technical skills by the end of the winter quarter of the second professional year. This will make room…for closely supervised clinical experiences prior to the more independent work done during the third professional year…An interpersonal skills course has been added to the spring quarter of the second year including topics (such as) inter -and intra-professional communication.

A summer curriculum will be added to the third professional year beginning in May, 1998. The benefits (of which)…will include a smoother transition from pre-clinical training to actual patient care experience and more patient care experiences for third year students.

An agreement has been reached with the Department of Ophthalmology and Visual Science at the University of Chicago to coordinate clinical, medical, educational and research programs with ICO. This is only the second such agreement between a college of optometry and a university ophthalmology program in the country…Among its benefits will be the creation of an O.D./Ph.D. program; increased opportunities for collaborative research; shared lecturers; and an expanded clinical base.

(The) faculty now has a voice in the deliberations of ICO’s Board of Trustees through elected representatives. A Faculty Council has been created with a written constitution and leadership provided through an elected Executive Committee.

In our efforts to develop external funding for research, we have made significant progress in improving our opportunities with various Federal Agencies by making certain we are in compliance – or making substantial progress toward compliance – in several areas from institutional protocols to record keeping.

ADMINISTRATIVE ISSUES
“We have thoroughly reviewed our organizational structures. We will shortly be submitting to the Board a revised organizational chart that reflects functions rather than individuals and is organized in a way to maximize our efficiency and service to our students and our patients.

Simultaneously with this review, we have taken steps to review all personnel and initiate changes to improve their efficiency. These include the creation of the ‘President’s Advisory Council’ to assist me in managing ICO. We are committed to diversity in our staff, faculty and student body and have taken steps to ensure a diverse ICO community.

FINANCE
“We have reorganized the Business Office to improve our financial management. We have completed a structured budgeting process with time lines and approval processes built in to insure that all ICO needs will be addressed in the budget process and properly prioritized within our educational and patient service commitments ….(and) to improve accountability.

We have also constructed a long-term debt management plan. ICO currently has an outstanding tax-exempt variable rate of indebtedness of $37 million dollars. We have been successful in negotiating productively to refinance this debt in a way that minimizes its burden on ICO and maintains our position of excellence in optometric education.

INSTITUTIONAL IMAGE
“How we see ourselves to a very large extent projects how others view us. For that reason, I have made improving internal communications (among faculty and staff) a high priority during the past year and will continue to do so.

We have attempted to address the information needs of our external constituencies, especially our alumni…This was the impetus for the creation of a quarterly newsletter. We are also in the process of creating an Internet mailing list of our alumni and developing a web site for ICO’s alumni and friends. We have initiated a mentoring program with the Illinois Optometric Association to link optometry students with practicing optometrists in Illinois, the majority of whom are graduates of ICO, furthering the ties between the College, our students and our alumni.

We have also created a public relations program with specific goals and objectives in the areas of media relations, community relations and greater visibility in professional journals and optometric associations. The public relations program contains a strong marketing component, chiefly (involving) the Illinois Eye Institute.

OPERATIONS
“The future of both health care and education will be greatly influenced by developments in communications. Without a significant increase in capital spending, ICO has moved forward aggressively in this arena through the efforts of our Information Systems Department.

Personnel management has been enhanced through greater accountability. Formal performance agreements have been created for each member of the administration, creating an objective measurement against which (each employee can be evaluated for his or her) performance.

PHYSICAL PLANT
“We are continuing to make necessary improvements to our (physical) plant. We recently installed exterior signage, increasing our visibility in the community and improving the marketability of our (Illinois) Eye Institute. We will shortly be changing our internal signage as well, making it more informative, user friendly, consistent and within Federal regulations.

Renovation of the Illinois Eye Institute is nearly complete. When finished, we will have a facility whose exterior and interior appearance matches the outstanding qualities of those who serve there.

At the same time, we have carefully evaluated the existing construction master plan, not only in terms of our needs but also within the framework of sound financial considerations and the need to maintain a competitive economic stance. As a result of this review, we have reduced the previous master plan by more than $23 million dollars over the next five to seven years.

REVENUE STREAMS
“We have made significant progress in increasing (the number of) alternative sources of revenue for ICO…(because) we cannot afford to neither compromise excellence nor over-burden our students with significant tuition increases.

We have begun with the creation of a marketing plan for the Illinois Eye Institute that recognizes that in addition to its educational mission the IEI must be competitive in its efforts to attract patients.

We have reinvigorated our commitment to fundraising, or ‘development,’ – so named in recognition of the fact that the creation of a significant philanthropic base is a developmental process (that occurs) over time.

In order to better fulfill our educational role to practicing optometrists – and to improve our revenue stream through education – we have adopted a more user-friendly stance toward continuing education or CE. We are in the process of creating a CE program (that will be) systematically planned and timed to coincide with the two-year cycle of CE requirements for licensure renewal in Illinois and one that stresses advanced competency.

We are also strongly committed to enhancing our efforts at student recruitment and retention, but please let me emphasize that this must not ever come at the expense of quality.

Our focus this year was to move admissions from a paper oriented (process) to more of a people-oriented process. In August, we held an open house for prospective students. An aggressive schedule of visits to undergraduate campuses for recruiting purposes has begun. Before the year is out, members of our faculty and staff will have visited more than 50 colleges and universities.

STRATEGIC PLANNING
“A Strategic Plan for an institution such as ICO…must do more than chart a course for the future. It must reflect the collective wisdom of the College. We have created such a plan and named it the Prescription for Excellence. It is now in the process of some final revision before being presented to our Board. It is available to all who wish to review it in its entirety. It is a living document in that it is intended to be amended as conditions and opportunities warrant. It addresses all aspects of our continued growth as an institution of health care education. And, as its name implies, it requires excellence as the standard of all our efforts. This is not a mere title, but a recognition of our potential and also of what will be required of those who will thrive in today’s health care environment…..I am confident that ICO and its students, faculty and staff will be among those who excel.”[3]

During this same month, Dr. Mullen was installed as Illinois College of Optometry’s fourth president at a ceremony that was held on October 18, 1997 in the Rockefeller Chapel on the University of Chicago campus.

CHAPTER THREE
PRESCRIPTION FOR EXCELLENCE
YEAR TWO
During Dr. Mullen’s second year at ICO, the benefits of his mandate for openness and communication among the student body, faculty, staff, alumni and administration became more apparent. Working closely with Janice E. Scharre, O.D., M.A., who had been appointed Dean/Vice President for Academic Affair in November 1997, a faculty opinion survey was developed and distributed to determine the College’s perceived strengths and weaknesses. The information was gleaned and processed into a series of positive actions that were designed to enhance ICO’s academic culture.

A similar survey was sent to students, requesting input on virtually every aspect of student life. Improved communication among the student body, faculty and administration produced a more user-friendly Student Guide; increased flexibility in student leave policies; and an expanded and simplified work study program.

The responses to an alumni-directed questionnaire would result in an initiative to freeze tuition, increased funding for scholarships and incremental reduction of entering class size.

In his second “State of the College Address,” which he presented on October 2, 1998, Dr. Mullen detailed some of the accomplishments achieved during the year.

FINANCE
“Let me start with our successful bond issue of $45 million dollars (in variable-rate, tax-exempt bonds by which ICO was able to successfully restructure the College’s debt. This freed $22 million in assets, which were previously held as collateral. Those assets were freed up to be applied to more flexible investments). This guarantees the sound financial footing we need to successfully continue ICO’s tradition of excellence into the next century…But the real significance of the bond issue is not in dollars, but in the confidence the financial community demonstrated in ICO’s future.

STUDENTS
“I am pleased to be able to report that the state of our student body – whose progress in advancing the profession is the yardstick by which we are all ultimately measured -remains extremely strong…We have implemented several new avenues for their input. Town hall meetings were instituted. The Dean’s Advisory Group has been reinvigorated and a student satisfaction inventory was administered last month, seeking input form every ICO student about virtually every aspect of student life.

(To enhance the students’ educational experience,) ICO continues an aggressive expansion of the externship program…(which has) grown from 13 sites in 1996 to 79 (sites which are) currently located throughout the United States and abroad…We have implemented an evaluation and monitoring process for our sites…(and) taken care to remain fiscally prudent during this period of expansion. We will continue to analyze our community-based sites, seeking to renegotiate financial arrangements when possible; increase patient volumes; and modify our time commitment to individual sites when desirable. External sites, such as (the ones) we have developed, allow students a greater breadth of experience. They allow students to choose diverse locations and types of clinical settings, better preparing them for the realities they will face as practicing optometrists.

FACULTY
“The state of the faculty is also strong. A revised Faculty Handbook, which consolidated the old handbook and academic policy manual – was developed cooperatively by the faculty and the Dean. During the past year, significant emphasis was placed on faculty scholarly activity….Faculty attendance at professional meetings increased by 71 percent during the past year…Twenty-seven faculty presented (papers) at last year’s American Academy of Optometry meeting. Publications by junior faculty have increased significantly.

The faculty has also made a concerted effort to increase research, specifically in securing external research funding. ICO received over $100,000 in external research grants in fiscal year 1997-98, including significant grants from the Pearle Vision Foundation and the Illinois Society for the Prevention of Blindness. To insure that progress continues in this area, we have been sending faculty members to AOA grant writing workshops as well as the Academy Research Symposium.

Continued improvement of faculty teaching effectiveness is a high priority. We have created a Faculty Teaching Circle, in which informal monthly meetings focus on various teaching topics. One outcome of these meetings has been the creation of student-faculty colleague groups. A faculty retreat featured guest speakers from the University of South Carolina and the University of Chicago who spoke on the importance of developing effective feedback mechanisms from students so educational techniques might be refined and improved at ICO.

CONTINUING EDUCATION
“Through our Institute for Advanced Competency, 197 practicing optometrists received 358 hours of continuing education. In this fiscal year, we have already provided 323 hours of continuing education for 270 optometrists. We have also entered into agreements with various members of the ophthalmic community to provide CE. Included are: Cole Vision, EyeQuest, Consolidated Vision Group, Vistakon and TLC.

ILLINOIS EYE INSTITUTE
“The Illinois Eye Institute continued to make great progress in successfully marketing its services to the community. Through a fiscally conservative strategy…including print and radio advertising, direct mail and an increased presence at health fairs and neighborhood events, IEI (patient visits) increased by 4 percent in 1997-98, while producing a 10 percent increase in revenue. Through the first two months of this fiscal year, figures indicate that patient encounters are up by 16 percent as compared to the same period one year ago.

Various venues for patient feedback gave been created, such as surveys and a telephone comment line. Responses are being analyzed and changes in IEI resource allocation will be influenced by patient response.

In the realm of managed health care, the College is committed to enhancing the role of the optometrist as the primary eye-care provider. Along with our affiliate, the University of Chicago, we are in the process of developing a university-based, comprehensive eye-care product.

TECHNOLOGY
“While focusing on human elements, we have not neglected the bricks and mortar side of ICO during the past year, as well as computer software and hardware. Compulink, a new clinical software system, is about to enter the testing and training phase. Our target date to have this system “live” is late January of 1999. The CARS system, our financial and administrative system, is approximately 75 percent complete. We have upgraded all of our desktop computers with the addition of Windows 95 and Office 97. (And) Internet access was provided to most desktop computers. Currently, a new library system us under evaluation and selection. The long anticipated One Card System, which will allow ICO students (to use) a single card for security access, identification and purchasing, is on schedule and will be implemented in 1999.

BOARD OF TRUSTEES
“With the support of our Board, we remained fully committed to increasing diversity at ICO last year. One outcome of this commitment was the appointment of ICO alumna, Dr. Millicent Knight, to the Board the first female African American to so honor her alma mater.

COMMUNITY
“(ICO has) successfully reached out to the community. The recently created Community Advisory Board is comprised of eleven individuals, representing area churches, schools, community groups, government agencies, and members of ICO Administration. (Its purpose) is to discuss areas of mutual concern and to formulate plans for improving the quality of life for all the residents of our community.

Our students have played a significant role in strengthening our ties to the community. Through patient care in the IEI and also through such neighborhood projects as unity day, the literacy program and donating toys for Christmas, students have helped show our care and concern for our neighbors on a very real, one to one basis.

ALUMNI
“As the largest college of optometry in the country, ICO benefits from having the largest number of alumni of any of the schools or colleges of optometry. Through newsletters, direct mail, individual and group meetings and receptions at various professional meetings, we continue to forge strong bonds with our alumni.

A benefit to our students, we hope, will be an increased commitment on the part of the alumni to the ICO Endowment Fund. We are aggressively pursuing deferred and major gifts from our alumni and our friends in the ophthalmic industry to add to our endowment.

OPHTHALMIC INDUSTRY
“We are continuing to reach out to our partners in the ophthalmic industry. The Practice Opportunities Symposium (which took place) this past spring was enthusiastically endorsed by representatives from a wide range of practice options. (This symposium provides the students with the opportunity to learn about all modes of optometric practice.) Through both… our alumni and our partners in the ophthalmic community, we have realized over $300,000 in pledges and gifts this year.

ACCREDITATION SITE VISITS
“During this past fiscal year, we benefited from two highly successful accreditation site visits: the Council on Optometric Education Interim Site Visit and the Primary Care Residency Reaccreditation. The COE visit confirmed that recommendations and suggestions made in its earlier report had been accomplished. The Primary Care Residency Reaccreditation was also highly successful as the accrediting team reported that all nine of its standards had been fully complied with. Preparations are now underway for the North Central Association accreditation visit in March of 1999…I am fully confident we will benefit from this examination and once again exceed expectations.

One year ago, I stood before you and announced that we had completed a strategic plan, our Prescription for Excellence (which would be) a living document to guide us through the coming year and into the next century….To date, of the 798 action items contained in the plan, 438 (items) or 55 percent have been completed. (Although) the Prescription for Excellence will continue to be our guide for the coming year…we have already begun the next phase of planning – identifying outcome measures, adding baseline data, and revising the plan to include new initiatives and linking a five-year operational budget to the plan.

As you know, this year we officially began our observation of our 125th anniversary as America’s oldest college of optometry. Over the years, the manner in which our profession is practiced and the way in which it is taught, has changed, but through it all our commitment to excellence has remained firm. With that continued commitment, I am confident that our progress over the next 125 years will be just as exciting.”[4]

It was during this academic year that Dr. Mullen led the school on a two-year journey toward excellence.

CHAPTER FOUR
JOURNEY TO EXCELLENCE
YEAR ONE
ICO’s 125th anniversary year (1998-99) marked not only a celebration of the College’s long history and its stature in the optometric profession. It also commemorated the beginning of momentous changes which would positively position the school as it entered the twenty-first century.

At the spring Interim Board Meeting, the Board of Trustees acted upon an alumni-inspired initiative and approved freezing tuition at the 1998-99 level ($22,668), while simultaneously increasing allocated funds for scholarship aid to $400,000 and gradually reducing entering class size for five years beginning in 2000. These directives had a crucial impact on ICO’s budget planning process, requiring mandatory expense reduction in order to maintain a balanced budget.

An ambitious $8.5 million campus capital improvement program – funded with revenues from the restructure of ICO’s debt – was completed during that year. The program included renovations to the physical plant; the purchase of new ophthalmic equipment; and the installation of extensive informational systems technology. With improvements to the campus’ external appearance along with other college-owned property, ICO participated in the continuing resurgence of community development.

Affiliation with the University of Chicago continued to flourish. A course in basic eye-care procedures for second-year University of Chicago medical students was developed and implemented.

In his “State of the College Address,” which he delivered on October 22, 1999, Dr. Mullen reflected on his years at ICO and the challenges that the College would face to maintain its leadership position:

“In preparing this year’s address, I found it useful to reflect back upon my arrival at ICO in 1996. At that time, I said three elements would characterize my presidency. (These were:)

1. The need to recognize the challenges that confront us and to clearly define them.
2. The importance of pervasive and detailed planning so we might marshal our resources and measure our progress in meeting these challenges, making adjustments as necessary.
3. Open and productive dialog among all members of the ICO family … the Board of Trustees, alumni, our many friends and partners in the ophthalmic community and businesses, and the residents of the community in which we are located.

I believe that our commitment to these three concepts provided the basis for significant progress at ICO during the past year. We have now successfully completed over 70 percent of the action items in our original strategic plan, Prescription for Excellence.”

Dr. Mullen further described in this same address some of the noteworthy accomplishments from that year as well as some of the challenges that lay ahead:

“We are in the process of (establishing) a faculty practice plan making ICO more attractive to (present) and prospective faculty.

Thanks to the hard work of our community based education staff, we have continued to expand our externship program…at over 100 sites throughout the United States and abroad. From these sites, combined with the Illinois Eye Institute, our students will benefit from more than 150,000 clinical teaching opportunities, significantly enhancing their educational experience. Student–patient encounters are up 68 percent compared to three years ago.

Our residency program has grown to include residencies in cornea/contact lenses and anterior segment/refractive surgery.

With the support of the Board of Trustees, we have embarked on a bold course to insure our position of leadership…(by freezing) tuition while simultaneously increasing scholarship aid. At the same time we committed to gradually reducing the size of future entering classes, beginning with a reduction by five for the class admitted in the year 2000.

To do this will be a tremendous challenge, but I am confident we can do it. However, these are not the only challenges facing ICO as we prepare for the next millennium. To maintain our position of leadership we must do the following:

• Continue to emphasize strategy and tactical planning with outcome-based assessment as the measure of progress.
• Amplify the voices of students in College affairs, including representation on the Board of Trustees.
• Continue to expand our recruitment of gifted foreign students beyond the confines of North America, while remaining a strong institution of choice for outstanding students from our neighbors to the north.
• Increase the size of the Board of Trustees, furthering its diversification. And recruiting members with needed expertise and philanthropic capabilities.
• Further enhance personnel relations within the ICO family, particularly as it pertains to fostering a positive attitude and respect for one another.
• Restructure the clinical education program to be more cost-efficient while we maintain academic quality.
• Accelerate the upgrade of instructional technology.
• Ensure that our curriculum is consistent with defined entry-level attributes.
• Develop and implement an advanced competency curriculum.
• Significantly increase the revenues of the Illinois Eye Institute.
• Implement a faculty practice plan.
• Continue to improve faculty scholarly activity with more externally funded research, clinical trials and publications.
• In cooperation with the University of Chicago, develop our role as a provider of comprehensive eye care services within the Chicagoland managed health-care market.
• Achieve continuing accreditation from the Council on Optometric Education.
• Achieve accreditation for the Illinois Eye Institute from the Joint Commission on Accreditation of Health Care Organizations, a first for an eye-care facility (that is) affiliated with a college of optometry.
• Launch major capital and deferred-giving campaigns to sustain an ongoing and significant development effort in keeping with our status as America’s largest college of optometry.
• Complete the cultural shift of the institution to one devoted to the continuous improvement of our programs, services and products.

Tomorrow night we will officially conclude our… celebration of our 125th anniversary. The highlight of the evening’s festivities will be the recognition of 125 individuals, organizations and institutions for their outstanding lifetime contributions to optometry. Some have contributed through research, others through practice, some through teaching, and some in the business world. Their contributions are as varied as their numbers…They have witnessed tremendous change in the way optometry is taught and the way it is practiced. They have learned to thrive in an environment of rapid change.

In the last year we have accomplished much…I look forward to reporting further progress in the years ahead.”[5]

Dr. Mullen then devoted the next year to the implementation of additional initiatives that had emerged during the previous identification and developmental period.

CHAPTER FIVE
JOURNEY TO EXCELLENCE
YEAR TWO
The mandate to successfully freeze tuition and increase the scholarship budget while maintaining a balanced budget and preserving the quality of education had a visible impact on ICO. Working on a 5-year budgeting plan, necessary expense reductions were made and continue to be implemented each year to achieve ICO’s goals.

A Voluntary Early Retirement Incentive Program was approved by the Board of Trustees, which took effect on January 1, 2000. Full-time employees with at least ten years of service and who are age 55 or older were eligible. Seven employees accepted the early retirement package. Responsibilities were reassigned so that, in most cases, those employees were not replaced.

The College worked diligently to increase income from non-tuition sources. Assets that could be invested grew by $6.5 million to more than $27 million since 1996. A Vision for the Future Campaign has been launched with the goal of growing the total endowment to $60 million by the year 2010. The Office of Institutional Advancement helped the President raise more than $1 million during the previous year.

Anticipating challenges such as the contracting student applicant pool and the changes in the healthcare industry, the administration tackled each situation head-on. Dr. Mullen reported these changes in his fourth annual “State of the College” address:

“We have had an outstanding year, thanks to every member of the ICO community. I am especially grateful to those who have played important roles in our ongoing strategic planning process. Much of our current and future success stems from those efforts.

It has allowed us to open new avenues of dialogue – within the college and within the profession, the healthcare industry and our constituents at large. It has allowed us to implement performance-based monitoring and measurement of our progress. And it has allowed us to positively engage faculty, administration and students in continuously improving our institution and our performance.”

Dr. Mullen then recounted some of the year’s achievements and strengths.

“Academically, we are stronger than ever. We have expanded externship sites to 118 (current sites) today…The (Illinois) Eye Institute and (these sites) now provide over 180,000 clinical encounters for our students each year. Our students’…pass rate on the National Board exams, at time of graduation, now stands at 94 percent. ICO has historically performed very well on the clinical sections of the National Boards and this year’s performance in Basic Science…significantly exceeded the national average.

Our student attrition rate is at an all time low of only 2.7 percent. We have expanded residency programs in cornea and contact lenses, refractive surgery and primary eye care…(We) have built research laboratory facilities and made significant technological improvements in our lecture centers.

Our graduates enter into practice better prepared to succeed thanks to significant improvements in our practice management course and programs such as the Practice Opportunities Symposium, Private Practice Club and ICO Placement Services.

Our affiliation with the University of Chicago’s Department of Ophthalmology and Visual Science stands unique among colleges of optometry. Our collaborative course for medical students speaks directly to our rigorous commitment to the arts and science of both medicine and optometry. We have also formalized our cooperative O.D./M.S. and O.D./Ph.D. programs with the University of Chicago.

Our faculty has enhanced its pursuit of scholarship. During the past year, a total of seven research grant proposals were submitted and six were funded. In addition, 21 articles were published in professional journals. Faculty representation in the American Academy of Optometry at the fellowship and diplomate levels stands at 87 percent up from 48 percent just four years ago.

Clinically, we are stronger as well. (There are) marked improvements in patient satisfaction and a 23 percent increase in Illinois Eye Institute revenues since 1997. Professionally, we have strengthened our outreach and built better relationships with other health care professionals and organizations through our Professional Advisory Board.

Financially, we are stronger than ever. Our (investment-worthy) assets have grown to more than $27 million, up more than $6.5 million in just four years. We have launched our Vision for the Future Campaign, with its goal of growing our total endowment to $60 million by the year 2010. Through a grant from the State of Illinois for $250,000, we have reestablished our indigent patient care program. We expect to reach thousands of high-risk patients in the coming year with this support.

We have also been able to freeze tuition at its level of two years ago (while increasing) the scholarship budget by nearly 50 percent…I want to recognize both the faculty and the students for independently and successfully launching and funding new scholarship programs to benefit students. Governance has grown even stronger through the Board’s concerted efforts to increase and diversify its members. We now have a voting faculty member on the Board of Trustees and student representation as well. But we cannot rest on our achievements and expect to maintain excellence. Challenges lie ahead. We must face them squarely. We can and we will.

Over the next few years, we have pledged ourselves to meet these challenges through continuous refinement of our strategic planning capabilities. Soon we will enhance patient care and clinical education by developing and implementing a Faculty Group Practice Plan.

In the face of a decreasing student applicant pool, we continue our commitment to recruit and admit only the most qualified students and assist them in managing the high cost of a quality education by continuing to freeze tuition and by increasing scholarship support.

Financially, we have committed ourselves to refining our financial planning in line with the goals of our strategic plan, Journey to Excellence. And we will continue to sustain and strengthen our capital and planned giving efforts. We will continue to enhance our academic culture through support of our faculty in their roles as teachers and through expanded opportunities for faculty research and scholarship. We will evaluate and modify our curriculum, striving to maintain an effective entry-to-practice model. We can prove our commitment to excellence in patient care by going forward with seeking accreditation from the Joint Commission on Accreditation of Healthcare Organizations.

The state of the College is strong because of the hard work and dedication of a great many people. Today, I would like to thank all of you…We’ve had an extraordinary year. We have an extraordinary future ahead of us as we continue to provide an outstanding education for future eye care professionals. I look forward to continuing on our Journey to Excellence with each and every one of you.”[6]

By meeting each of the Prescription for Excellence’s goals and applying the strategies in the Journey to Excellence, ICO is now prepared to face the future with confidence and a commitment to excellence.

CHAPTER SIX
COMMITMENT TO EXCELLENCE
WHAT LIES AHEAD

During these early years of the twenty-first century, both optometric education and the profession of optometry are facing new challenges: challenges that are both necessary and inevitable. Dr. Mullen predicted what the profession and Illinois College of Optometry might face in a guest editorial that appeared in the Journal of the American Optometric Association, (September 1999).

“The challenges facing ICO – to a greater or lesser extent – are the same issues that face many of the schools and colleges of optometry. In general I see the following trends in optometric education:

• We will see a lessening of our dependency on campus-based clinics for the clinical education of third- and fourth-year optometry students. Driven initially by economics – but, I believe, providing for greater diversity of educational experiences – we will see more community-based training sites or externships for fourth-professional-year students and some third-year rotations.
• Campus-based clinics will remain valuable for first- and second-year students.
• College-based clinics will serve a significant role as (the) faculty practice becomes more important as a means to enhance faculty income and improve (both) schools’ and colleges’ ability to recruit and retain highly qualified clinicians.
• We will see a movement away from traditional classroom teaching toward more technology-assisted self-learning through the rapid advances being made in communication and computer-based technology. The college, however, must be prepared to assist the faculty in changing their teaching strategies.
• Acquisition of critical analysis skills will become as important as a solid foundation in the basic and health sciences.
• There will be recognition that the function of a school or college is to prepare doctors of optometry for a life-time of learning in their field.
• We will have to redefine the entry-level attributes of our students and modify our curriculum to emphasize a lifelong commitment to learning.
• While graduates must learn to be well-grounded in the fundamentals of their profession, the purpose of this grounding must be to position them to continue the learning process.
• Students must learn to focus on the opportunity for interaction with faculty and with one another while on campus. They must commit to a philosophy that emphasizes the acquisition and appropriate application of knowledge over information absorption and memorization.
• We will see the development and utilization of a national faculty in several disciplines, linked through developing technology. All schools and colleges of optometry will be able to access a faculty made up of our very finest educators.
• Cooperation between optometry and ophthalmology that began at the New England College of Optometry’s Boston clinics and carried forward at PCO (Pennsylvania College of Optometry) with Hahnemann University and at ICO with the University of Chicago – will continue and intensify.
• We must then be prepared to offer meaningful advanced competency education to practicing optometrists as a core value of optometric education.
• Residency programs will continue to increase, but at a more modest rate. I believe the future direction of the profession of optometry will be fueled by the economics of the managed care marketplace.
• The cooperative environment among opticians, optometrists, and ophthalmologists that exists at the academic level and – in several instances – in other practice modes will intensify.
• Distinctions in practice modes will continue to blur among the three groups. Economic realities will override emotional opposition and force closer cooperation. Individual claims of priority and historical territorial imperatives will be forced to give way.
• Quality assurance programs and advanced competency certification and accreditation will become increasingly important.
• The expansion of the scope of practice of optometry will consist mainly of amendment and clarification to existing practice laws.
• Ultimately, all states will grant appropriate and extensive prescription authority to optometrists.
• The expanded use of laser technology by optometrists will evolve slowly over the next two decades.
• Consultation among practicing professionals will take advantage of advances in technology. Consultants with national eye centers of excellence will become the norm, as precise retinal images and other data are instantly transmitted from one point to another in real time.
• We will see fewer independent, private practitioners of optometry in the future and more multi-practice settings, more optometrists in HMOs, hospitals and other institutional settings. What is often termed ‘corporate optometry’ will continue to expand for the foreseeable future.
• Schools and colleges of optometry will recognize their responsibility to expose their students to a wide variety of practice modes and to discuss each opportunity openly and honestly.
• Health care third-party payers will continue to exert enormous influence on the practice of health care-eye care included. In this vein, it is imperative that optometry solidify its position as the primary eye care provider within the managed care market.

We live, learn, teach and practice in tremendously exciting times. I believe the future of optometry is as great as our ability to translate our vision for the profession into strategic and tactical plans of action – as promising as our courage and tenacity to implement those plans.”[7]

——————————————————————————–

[1] Excerpted from “Interview with Charles F. Mullen, O.D.” Journal of the American Optometric Association 1999; 70:556-60. (Copyright © 1999 by the Journal of the American Optometric Association. Reprinted with permission.)

[2] Excerpted from Interview with Charles F. Mullen, O.D. Journal of the American Optometric Association 1999; 70:556-60. (Copyright © 1999 by the Journal of the American Optometric Association. Reprinted with permission.

[3] Excerpts from “State of the College Address – October 01, 1997” which was delivered by Dr. Charles F. Mullen.

[4] Excerpts from “State of the College Address – October 02, 1998” which was delivered by Dr. Charles F. Mullen.

[5] Excerpts from “State of the College Address – October 22, 1998” which was delivered by Dr. Charles F. Mullen.

[6] Excerpts from “State of the College Address – October 20, 2001” which was delivered by Dr. Charles F. Mullen.

[7] Excerpts from “Interview with Charles F. Mullen, O.D.” Journal of the American Optometric Association 1999; 70:556-60. (Copyright © 1999 by the Journal of the American Optometric Association. Reprinted with permission.)

First published in 2001 by
Illinois College of Optometry
3241 South Michigan Avenue, Chicago, IL 60616 USA

Cover design:
Anistatia R. Miller
Jared M. Brown

Book design:
Alan Pouch

Photographs:
Ray Reiss, Sparkfactor
Andrew Fils, The Paul Studio
Alan Pouch, Illinois College of Optometry

Preface & commentary:
Barbara B. Renard
Copyright © 2001 by Charles F. Mullen, O.D. and Barbara B. Renard

All rights reserved.
No part of this book may be reproduced, stored in or introduced into a retrieval system, or transmitted in any form or by any means (including electronic, mechanical, photocopy) whatsoever without written permission from the above publisher of this book, except by reviewers who may quote brief passages to be printed be a magazine or newspaper.

ISBN #: 0-9652759-Printed in the United States by Paperback Mfrs.