The American Optometric Association (AOA) Board of Trustees addressed some of the concerns of optometrists across the U.S.-unilateral pricing policies (UPP), the Affordable Care Act (ACA), scope of practice, and more-during a session at Optometry’s Meeting.
Seattle-The American Optometric Association (AOA) Board of Trustees addressed some of the concerns of optometrists across the U.S.-unilateral pricing policies (UPP), the Affordable Care Act (ACA), scope of practice, and more-during a session at Optometry’s Meeting.
During the session-which was approved for CE credit for the first time-the board briefed the audience on a number of hot topics and responded to questions from attendees.
1-800-CONTACTS is waging a legislative war against UPP in 14 states and has already won in its home state of Utah-for the time being, at least.
“The AOA got mobilized, worked with our state government relations center (SGRC) and with those state associations, encouraging them to fight the legislation and worked on strategies on how to do that,” says AOA Trustee Samuel Pierce, OD.
Johnson & Johnson Vision Care and Alcon filed an injunction against the anti-UPP law in Utah, which was upheld, but then the 10th Circuit Court of Appeals overturned the injunction, allowing the bill to go forward.
“However, the hearings on that injunction have been fast tracked. There should be a decision pretty soon-within the first week or two of July-regarding whether or not that bill will be challenged,” says Dr. Pierce.
AOA Trustee Barbara Horn, OD, discussed the AOA’s renewed focus on converting student members into full members.
“Obviously, their membership is critical to this organization,” she says. “The past year, we found that 50 percent of the students are transitioning their [student] membership into AOA active membership. So, we’re facing a crisis with new membership.”
Dr. Horn says that the AOA has created a project team dedicated to encouraging students to transition their membership. She says the team found that students that attend the congressional advocacy conference transition at a higher rate than those who don’t attend. For the 2017 Optometry’s Meeting, the AOA will combine the meeting with the congressional advocacy conference and have a large student summit.
“We’re asking all of the organizations to come together and support the students in getting them there-as many students as we can-to show them advocacy for our profession,” says Dr. Horn.
This week, the Supreme Court ruled in favor of the Affordable Care Act (ACA). Since it’s adoption, ACA has brought with it a certain degree of uncertainty amongst the healthcare community.
“There certainly will be more legal challenges to the ACA, but this is probably the last constitutional challenge to the ACA law,” says AOA Trustee William Reynolds, OD. “I know this is going to shock you, but there are several things that need fixing in this law. What we think is that thismight open up both sides to be going in and making some changes to the law
“If we do that, there’s some anti-optometry forces-medicine, insurers-that want to go in and take away the children’s essential benefit. So, that’s something we’re working on right now, to defend that,” says Dr. Reynolds.
One attendee asked if there was any way for ODs to obtain more training in areas such as surgery-or would optometrists be forced to stay in the shadow of ophthalmology?
“The only way is through state advocacy,” says AOA President David Cockrell, OD. “It’s all doable through legislation-it’s not going to happen any other way.”
Preparing the next generation of optometrists was a main topic of concern for both the board and attendees.
AOA Vice President Andrea Thau, OD, says that the Accreditation Council on Optometric Education (ACOE) recently took a look at the standards for new schools-another area of concern for many ODs. ACOE issued new guidelines that are effective as of this year.
“Those guidelines really strengthened and slowed down the whole accreditation process for a new school. So, it actually takes them longer, there are more steps, they have to be more careful,” she says. “And the reason for that is that there were some 20 years that went by in which we had no new schools, and then all of the sudden, they all cropped up. There was a realization that the prior existing standards were really not sufficient for this day and age.”
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Dr. Thau says ACOE is in the process of looking at thestandards for existing schools. It will be asking all stakeholders for input, so Dr. Thau encourages AOA members to offer their suggestions.
“The one and only way we can make it better and make sure that our schools and colleges maintain those standards is through ACOE,” she says.
One attendee expressed concern that new graduates were not being adequately prepared to practice to the full extent of their scope of practice.
“In the old days, we used to say ‘Educate and then legislate.’ Now that things are moving so quickly in the states, the schools are very responsive to what is happening in the states,” says Dr. Thau. She says that the new standards for existing schools will be more rigorous. “What’s important is for all of us to work together to advance our profession and to make sure that each and every student is someone that makes us proud to call a colleague.”
As MDs move away from private practice and toward major healthcare systems, one attendee asked if the board sees optometry following suit in the coming years.
“I think that private practices will still be available in 15 to 20 years, but it’s going to look differently,” says AOA President-Elect Steven Loomis, OD. “Optometry has a long history of being independent. I think what we will see in the future is more practices that are group practices because the cost of running a practice with one doctor and seeing just a handful of patients a day just is not sustainable with reimbursements the way they are.
“I think it’s important that we always be a part of the larger system. ACOs are going to be a part of that system, so it’s going to be important for optometry to affiliate with ACOs. It’s going to be important for optometry to recognize its role in the healthcare system, and that is that we are the primary eyecare professional,” he says.
Dr. Loomis says that a major opportunity for eye care will present as the population ages. The difficulty, however, is making sure that optometrists continue to integrate into the system, he says.
“Ten years is an incredibly long time for us to predict given the state of change of health care today,” says AOA Secretary-Treasurer Christopher Quinn, OD. “I can almost assure that the very traditional type of optometry focused on refractive care will not be the way optometry looks in 10 years. Our healthcare system will need optometrists to step up and play an important role as primary care providers.”
Toward the end of the session, an audience member asked the board why there was not a more diverse representation on the board considering the profession’s demographics are increasingly female and Asian. The board is completely white and includes only two females out of 11 positions.
The audience member asked what the board was doing to address this dichotomy.
Dr. Thau says that when she entered the profession, she was one of the few women in the room, and that some of the doctors at the time told her that the “girls are going to ruin the profession.” Statements like that have helped motivate her pursue leadership positions.
“We’ve been working really hard-I’ve personally been working hard, and I know every person on this board has been working really hard-to try to cultivate leadership and future people to run for the board,” says Dr. Thau.
“There are cultural differences, generational differences that we have challenges with. There are absolutely no barriers for them. I spoke with about 10 Asians yesterday and asked them to run for the board because I’m tired of hearing this question, and there are a lot of talented people out there,” she says.
But it takes time and a lot of work, starting at the state level, says Dr. Thau. She says the AOA is seeing a shift culturally becausecertain groups are not expressing as much interest in joining the organization.
Dr. Cockrell says that the demographics will eventually translate into a more diverse board.
Dr. Cockrell says he was approached by an Asian man recently who told Dr. Cockrell that he looked up at the board and saw “a bunch of old, white guys.”
“In another 10, 12, 20 years, this board is going to look completely different. I don’t know if there’s going to a minority group, but this board will certainly be mostly women, and it should be as the demographics catch up,” says Dr. Cockrell.
“The gentleman last night said, ‘We just don’t like to join things.’ And I said, ‘Well, you’re going to have to join things, I don’t know what else to say.’ He specifically talked about his own culture, how they really don’t like to join, and that there’s got to be a different way for them to achieve leadership without joining,” he says. “I didn’t have an answer for that. We encourage everybody to step up and do it, but to get up here, you have to work your way through.”