Speaker: Eye care work force will be unable to meet demand

SAN FRANCISCO – By the year 2020, the Affordable Care Act, changing ethnicity and new treatment modalities will increase the need for eye care services beyond what optometrists and ophthalmologists can provide, according to a speaker here at the IOMED program of the American Society of Cataract and Refractive Surgery meeting.

Richard Edlow, OD, told attendees at the Integrated Ophthalmic Managed Eyecare Delivery program, “We’re coming off a 20-year period where we could be complacent because the 65-and-older population was flat. It’s about to take off. Fasten your seat belts.”

Between 2010 and 2020, the U.S. population is increasing 5.7%, while there will be a 36% increase in the 65-and-older population, Edlow said.

“We will need to provide about 100 million eye exams in 2020,” he said. “And the Affordable Care Act (ACA) will add another 40 million currently uninsured people into this mix.”

By 2020 there will be an increase in demand of 10.8%, “and that does not include increased utilization, new treatment modalities and changing ethnicity of the U.S. population,” Edlow said.

“According to the American Optometric Association Manpower Study, we will have an oversupply of optometrists until 2017, and then it will shrink,” he said. “The American Academy of Ophthalmology said there were too many eye doctors. Those studies were flawed because they did not take into account the aging population, the ACA, the changing ethnicity of the U.S. or new treatment modalities. Oversupply, if it exists in your specific region, will disappear rapidly.

“There are three new schools of optometry graduating their first class this year, and another school will come online in 2016,” Edlow continued. “Every year 1,350 new optometrists are coming out, but 420 are retiring. We’re not increasing a whole lot.”

A built-up retirement demand also exists, he said.

“Retirement decisions were thrown off by the economic reality of the stock market in 2008, and a lot of eye doctors weren’t retiring for a number of years,” he said.

In 2000, 82% of the U.S. population was Caucasian, but by 2030 it will be less than 70%, Edlow said. The African-American population is increasing gradually, and the Hispanic population is increasing more rapidly.

“This will impact what we do every day,” he said.

Edlow explained the impact of the increase in the number of female eye care practitioners.

“Fifty percent of ophthalmology residents are female, and 64% of optometry graduates are female,” he said. “Every study indicates that women work about 85% of a full-time employee. If we take this into account, we have 51,000 eye doctors, and we’re going to need 65,000.”

Edlow added that the typical provider now works a 40-hour work week, not 50 to 60 hours as in the past.

“That’s a change in the workforce supply-demand phenomenon,” he said.