In the following comprehensive analysis, Dr. Kenneth Myers critiques the Eye Care Workforce Study prepared by Lewin Associates and released by the American Optometric Association (AOA) and the Association of Schools and College of Optometry (ASCO) in 2014. The Lewin Study (when “excess capacity” of 32% is taken into account) is consistent with previous eye care workforce studies, including Rand (1995), Abt. (2000) and Myers (2014), in finding an excess of optometrists. The most revealing finding of the Study is that optometrists function only at 68% of their practice capacity.
Lewin states “In fact, our estimates indicate that there is a significant excess supply (12,672 FTE in 2012) and though it declines modestly over the forecast period it remains substantial at about 9,000 FTE by 2025. Accounting for two of the factors that could increase demand, increases in insurance coverage under the ACA and increased prevalence of diabetes excess supply is reduced substantially to 4,000 FTE by 2025.” Dr. Myers questions the plausibility of these Lewin predictions “that could increase demand”, as well as Lewin’s assumption all ophthalmology shortages will be filled with surplus optometrists at the rate of 1.36 FTE optometrists filling 1.0 FTE ophthalmology shortage. He also believes the effective optometry surplus will approximate 11,000 FTE in 2025.
The author discusses the Bureau of Labor Statistics (BLS) prediction of a 24% growth in employment or 8,100 additional optometrists by 2022. This prediction is obviously not consistent with the Rand, Abt. Myers and Lewin studies. This optimistic prediction has been cited as the rationale for the development of new schools of optometry. The reliability of the data and methodology used by BLS in making this prediction need to be evaluated and reconciled with the findings of the previously cited eye care workforce studies.
The author attributes the optometry surplus to a significant increase in the number of graduates from optometry schools and colleges. Since 2006, six new schools in CA, AZ, TX, MA, KY and VA have been founded and three more are under consideration in IL, NC and WI. Already, the number of graduates has increased from 1029 in 1985 to 1600 in 2014. When all new schools reach full enrollment, the number of annual optometry graduates will further increase to 1900. Also, the addition of new optometry schools dilutes the already flat student applicant pool.
All academic leaders in optometry are encouraged to read the entire Lewin Study and draw their own conclusions about the optometry workforce. The terminology used in the publicity associated with the Lewin Study’s release was ambiguous with no reference to an excess or surplus of optometrists. “Adequate” is not the same as surplus. It is also suggested that the leadership review the current oversupply situations in veterinarian medicine and the legal profession and the impact on employment opportunities for graduates and number of applicants for admission in these two professions.
The unmet need for optometric services in rural and inner-city America was not addressed in the Lewin Study. Presumably, this omission occurred since inclusion of optometry in key Federal incentive programs such as the National Health Service Corps and Title VII would be necessary to be a realistic practice option. Only 20% of Federally Qualified Community Health Centers provide eye care services.