Dr Aaron Lech
ClearVue Eye Care
Roseville CA USA
Let me start by assuring you that I do not consider myself a guru or a health care demographic soothe-sayer. I put my pants on one leg at a time. Like most everyone else in the eye care industry, my successes are the product of three things: a supporting team of work colleagues; a commitment to innovation; and vendor support for diagnostic solutions, data management and utilisation.
Still, as I look at the eye care market in the US and Australia, I can say with a certain level of guru-like confidence: I am compelled to believe that the future of optometry is quite bright.
As practitioners of optometry in Australia, you have been blessed with two significant studies, which, when combined with current demographic changes, reveal the amazing opportunities for optometrists nationwide.
In 2005, The Eye Health in Australia study1 was published, setting out a background regarding the epidemiology of eye disease and injury in Australia. Based on data from the WHO (World Health Organization) and the IAPB (International Agency for the Prevention of Blindness), the study made clear that the optometric community needs to pay attention to the impact of population ageing.
The projected need for care
Analysis of the study data, including the number of patients that required active management of disease in 2002 and the projected need for care by 2032, indicates that over six million Australians will require medical eye care services. This doesn’t even include the surveillance of additional disease suspects and the treatment of uncorrected refractive error.
Further review of changing population demographics by 2032 reveal that Australia will see a population shift among individuals over 55 years of age to the tune of 4.5 million people. This leaves a total of 8.9 million people requiring much closer surveillance. The shift represents a change in the ratio of patients likely to need eye care services from 1 in 5 to 1 in 3 (roughly 33 per cent of the population). When combined with the fact that an estimated 9.7 million Australians had at least one sight problem in 2002, greater than 50 per cent of the projected population will need some form of optometry service.
The second study, Optometric Supply and Demand in Australia: 2011–2036,2 published in Clinical and Experimental Optometry, set out to answer the question that troubles many optometrists: ‘are there too many of us?’ According to the conclusions of this study, there is a coming surplus of 1,200 optometrists given current demand for Medicare services (except in Queensland, Tasmania and the Northern Territory).
However, the study seemed to overlook a few key items. First, its assumptions were based on Medicare service demand only (which we all acknowledge is a moving target and is not the only reason patients seek our care). Second, ageing and disease demographic analysis was given minimal attention.
In fact, if you combine the findings of the optometric workforce supply study with the current trends in ophthalmology training programs and the projected epidemiology demands, a significant opportunity seems to be at the doorstep of Australian optometrists.
Table 1. Over six million Australians will require active management
of eye conditions by 2032
When we note the ophthalmology workforce changes and projected graduation rates for the collective eye care profession, the ratios of providers-to-patients is quite favourable. In the ‘Workforce Study’ an assumed ratio of 18 optometrists to 100,000 members of the population was projected. Adjusting for static ophthalmology supply and increasing population growth, ratios could likely be closer to two ophthalmologists to 100,000 and 14 optometrists to 100,000. Essentially, we have a tsunami of baby boomers affecting both patients and providers.
If these modest adjustments are accurate and the ageing population exerts the pressure on services similar to countries such as the US, the future is indeed bright. For optometry, these ratios indicate that an average of 3,500 patients will require care by each optometrist in Australia (7,100 x 50 per cent = approximately 3,500).
With this type of demand, optometrists must prepare by investing in the systems, equipment and education necessary to take our place in this new millennium of opportunity.
As I say, I am not a guru or a health care demographic soothe-sayer, but I am compelled to believe that the future of optometry is quite bright.
Founder of ClearVue Eye Care in Roseville, California, Aaron Lech is a recognised innovator in the optometry field, and has pioneered diagnostic practice strategies over the past 15 years. In 2017, as a guest of ZEISS Australia, Dr Lech conducted a six-city tour of Australia and New Zealand to discuss how optometrists can improve efficiencies in a rapidly changing market.
1. Commonwealth of Australia. Eye Health in Australia; a background paper to the National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss [Internet]. Canberra: Department of Health; 2005 [cited 2018 Apr 17] Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/1A5409787D800F2CA257C73007F12F3/$File/cov.pdf
2. Healy E, Kiely PM, Arunachalam D. Optometric supply and demand in Australia: 2011-2036 Clin Exp Optom 2015; 98: 273-82