Nostalgic for the optometry of “yesteryear”? – Tips4EyeDocs Weekend Edition

When eye doctors get togehter, either at a meeting or at a dinner, nostalgic thoughts occasionally captivate the participates to remember what optometry was. Some may even call it optometry’s “golden era”.  Today’s current optometrist may not appreciate that time period.

I talked with several 40+ year practitioners about that era.  Back then, optometrists were careful about the outward appearance of their offices.  Many sought a professional appearance by locating their offices in non-retail settings.  Some dreamed of going beyond what was then standard by actively seeking state legislation to use diagnostic drugs to examine the eyes.  But the majority of optometrists focused on “vision analysis”.

Examination fees were set mainly to accommodate a vision analysis and it seemed enough to cover the cost of the basic lane equipment . There weren’t retinal cameras or scanners. Some had isual field bowl tester rather than the felt tangent screen.  Some had non contact tonometers. But total equipment costs were modest then and it seemed that net margins of  vision analyses and ophthalmic goods were sufficient to allow for a comfortable lifestyle.

The competitive environment was much less then.  Most were independent private practices that just “hung their shingle out”.  Even if there were more than one optometrists within a single block, doctors still expected to see their practices busy within the second or third year.  Advertisement or discounting seemed unnecessary as patients were loyal and remained with the same doctor for many years.

The optometry itself was uncomplicated. With mainly the vision analysis as the centerpiece of a doctor’s visit, it was simple to just detect a pathology and refer. There was no expectation of managing it.  As long as the ophthalmologist did not have an optical shop, the optometrist would eventually see the patient back again.

Most optometrists welcomed new optometrists to the area because they belonged to the county and the state societies. Each doctor knew that whatever another doctor said or did, the “tribe” (of optometrists)  did not fear much because each trusted the other that they would uphold the common ideals of all optometrists.

Managed care did not seem prominent.  New graduates could depend upon managed care patients to give a boost at the start and whenever the patient  returned with or without vision benefits, the patient eventually returned to them.

Alas, this kind of optometry seems anachronistic. It has been superseded by a host of issues that seems to rent the profession into fragmented pieces.  Even the common goal of “optometry first above all else” seemed hollow today. The distrust is so palpable that it seems to be irretrievable.  I always wondered whether this issue or that issue really meant much to but a small fraction of the overall optometrists and how it seems to become the battle cry for the many more.

As any child that matures into adulthood, it seems that optometry has also matured to an organization that has to handle many more complex issues than ever before. The task for today’s optometrists is to retain “optometry first above all else”.

About Richard Hom OD, MPA

Dr. Hom holds Doctor of Optometry and Masters in Public Administration degrees and practices family eye care and consults on public policy, health information technology and program evaluation.
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