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AOA's Latest Battle For Optometry: What’s Changing & What’s at Risk
00:46:38
Optometry is facing some of its biggest challenges yet — from Medicare reimbursement cuts to scope expansion battles and new legislative threats that could redefine the profession. If you think these issues won’t impact your practice, think again.
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- [00:00]
Jackie Bowen
Foreign.
- [00:07]
Eugene Shotsman
Welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Eugene Shotsman. And today we're diving into the role of the American Optometric Association. We talk about its impact, its challenges, and what it's doing for the profession right now. So here's an interesting stat. AoA member doctors report earning 13% more on average than non member doctors.
- [00:28]
Steven Reed
Why?
- [00:29]
Eugene Shotsman
Well, you'll hear directly from today's guests and see how they explain the correlation. Joining me today are Dr. Steven Reed, he's the AOA president, and Dr. Jackie Bowen, she's the AOA president elect. And here are just a few topics that we're going to cover. Legislative fights that directly impact your practice. We're talking about Medicare reimbursement, vision plan reform and the growing push for optometric scope expansion. We talk about the wins, the roadblocks and what's next, including what's happening at the state and national level that could potentially, potentially impact and possibly reshape the future of the profession. We talk about the reality of these not a doctor bills that we're hearing about, why they keep surfacing and what they could mean for optometry if they gain traction. And we also discuss a question that's kind of worth asking. If the AO8 didn't exist, what would optometry look like today? If, as you think about that answer, the answer you hear might not be what you expect. Throughout the show, you're also getting to know Jackie and Steven a little bit and you're going to hear about what shaped each of their desires to volunteer and just overall what their respective journeys have been like. So hopefully after listening to the episode, you'll have a better idea of what the AOA is doing for the profession and also whether you want to get involved in some way. So before we jump in, make sure you're subscribed on YouTube, Spotify, Apple Podcasts or wherever you listen so you don't miss any upcoming episodes. And if you have feedback, ideas, or just want to continue the conversation, you can always reach me@eugene shotsman.com let's get started. And here's today's Power hour. All right, Dr. Steven Reed, Dr. Jackie Bowen, welcome to the Power Hour.
- [01:59]
Steven Reed
Well, thank you. Appreciate you having us.
- [02:01]
Eugene Shotsman
All right, so I mean, we have a lot to cover in today's show and I think I'm just going to get right into it and jump right to it. I think there is a contingent of people that listen to the show and they have a really good idea of what the AOA is. I think there's going to be some people who may have might be surprised when they hear you talk about the types of things that the AOA is working on. And then I think there are some people that have less familiarity with what the AOA is and how the AOA truly impacts the industry. So maybe that's where we'll start is I'll ask you and Stephen, I'll ask you to comment first. Is that now. So describe for me what the AOA is and what impact it has on our industry. And you know, I bet you could probably give a four hour lecture on this. But I'll ask you to kind of keep it to just a minute or two.
- [02:50]
Steven Reed
Okay, I'll do my best to keep in a minute or two. Well, first of all, Eugene, I appreciate the question because the AOA is kind of nebulous to some people. It's a great way to just define this. Quite simply, we are a group of volunteers. So the AOA is not a paid organization. We're not doctors of optometry who have salaries from aoa. We're out there volunteering for our profession and we all work together for the benefit of not only our members, really the entire profession, even if you're not a member. So our mission statement is really twofold and number one is to advocate for the profession. Anything that we need to do to promote or to protect or to fight against what's not good for optometry and not good for patient care, then we're going to do that and we're going to promote, of course, the things that are the other side of that is that we serve our member doctors in meeting the eye care needs, the public. We have a lot of benefits out there. I missed one word. Eye and healthcare. We threw that in there because we want our patients to understand that it's not just about eyes, it's about your total health care. And so the AOA emphasizes that in trying to make people understand the need for a comprehensive eye examination as part of their overall healthcare. So quite simply, those are our twofold mission statement. We advocate, we do all day long and then we try to serve our member doctors and we do this for the entire profession as a group of volunteers. Just on the side too, we do have a staff that works for the AOA and they are paid, of course, but that's part of being a nonprofit organization.
- [04:27]
Eugene Shotsman
Yeah, Jackie, you want to add anything or any particular areas you want to zoom into.
- [04:32]
Jackie Bowen
Stephen mentioned that we are a volunteer organization and that number is pretty staggering. There are over 300 doctors who volunteer a lot of time, some for many years in a row, some for just brief committee work here and there. But it takes a large number of people to, to keep this train rolling.
- [04:50]
Eugene Shotsman
Yeah. So now let's zoom into some of the work that these volunteers and the staff that the AOA has are doing for the industry. Like maybe let's take the big advocacy bucket because I know it's a big one and maybe just like describe some of the, some of the wins from the last year and maybe then we can go deeper into wins over the past decade.
- [05:15]
Steven Reed
Okay, sure.
- [05:16]
Jackie Bowen
Advocacy is a word that we use frequently and I always like to make sure to clarify that when we at AOA and with our affiliates talk about advocacy, we're primarily talking about legislative advocacy because our profession is very unique. Our boards can't individually decide how we operate. So we are very dependent on grassroots relationship with legislators at the state level and at the federal level. So at the aoa, we have full time attorney attorneys and lobbyists whose job is to promote our profession, create connections with legislators, and make sure that we have the pathways in order to achieve what we need to. With aoa, one of the biggest wins every year is that every single year Congress wants to cut Medicare reimbursement. And that has happened this year and this time a cut did go through. So the work has sort of shifted rather than, you know, we defended that cut, but it happened. And so now we're aiming, aimed at not only stopping the cuts ongoing, making it so that that can't happen every year, but also seeking some compensation for so far this year, the cuts that we've experienced as providers.
- [06:32]
Eugene Shotsman
And I think that's really important to recognize that, you know, in an environment where costs are continuing to go up for optometrists across the country, that, you know, the, the ways that optometrists get paid continue to either not increase or in the case you're describing, is actually decreasing. So, you know, let's zoom in on that a little bit more. And Stephen, what are you doing to help support this particular initiative?
- [07:01]
Steven Reed
Yeah, well, lastly, we have kind of a seven pronged approach. We'll call that. I'm not going to go into all seven points in regards to our, what we call, why I'm going to say vision plan issues, because that's mainly where this comes into it here. So the biggest thing is making sure that we listen to our members because every day members have concerns about, say, a lack of reimbursement. Perhaps they're trying to get a particular panel and they can't get on or something like that. Maybe they want to do something like be on a medical plan, but they can't because they have to be on the vision plan first and they don't want to issues like this. And so we have formed a resource at the AoA. If a member has a concern, they can simply send an email, stopplanabusesoa.org and that is directly handled by our staff, in particular Kara Webb, who's our chief strategy officer. And we want to make sure that our members know that if they have an issue, somebody's on their side. Because what happens every day, Eugene, very often in our offices, you may get denied for a claim and say, look, I don't have time to fight this, I don't have time to get on a phone call. My staff doesn't, let's just forget about it and move on. And that results in thousands of dollars that can be lost. We did a little math and just as a result of this stop plan abuses@aoa.org we have brought back in almost $3 million to doctors offices as a result.
- [08:29]
Eugene Shotsman
So that'd be the first million dollars.
- [08:31]
Steven Reed
About $3 million. Yeah. And it's more now. This math was done a little while back and that continues to grow.
- [08:37]
Eugene Shotsman
So this is one of those areas where you're kind of, you're looking at this and you're saying, hey, let's take the responsibility off of the doctor's shoulders. We know how to, how to work with these medical plans and with these vision. Vision plans. And we can, and we can do this in mass. And also we can look at the trends and see if there is a bigger picture that one individual office can't see, for example.
- [09:05]
Steven Reed
Yeah, yeah, exactly, exactly. And because we have the contacts, we're able, as you said, to get in touch with the plans and get results quickly. If you want to see kind of a report card about how we're doing on that, there's an email that goes out five days a week, Monday through Friday, called AOA First Look. And within that there's a separate box, kind of a grayish looking box. And in that box at the bottom, it highlights a particular, say, vision or medical plan issue that a patient brought to us, the response as to, you know, what we're doing about that and if we've gotten a result yet. And so that's kind of a daily report card as to how we're doing it. So yeah, we like to say it's an extra staff member for your office. And it truly is in that regard.
- [09:47]
Eugene Shotsman
Well, and I think that there's no, no greater villain for the everyday optometrist in some cases when they're, when they're, when they're looking at their bottom line perhaps than the, than the Vision Plan that hasn't raised Reimburs. And in knowing that there is an advocacy component to the AOA that supports the practices and potentially, potentially solving both the individual simple thing, or I guess, kind of small picture things, but also the big picture is really important. So what else? And Jackie, maybe you can comment on what else you. That the AOA is doing to help practices in this particular arena.
- [10:27]
Jackie Bowen
One of our recent big, exciting wins is at the state level. Many, many states are legislating for vision Plan laws to be changing and hold these plans accountable. In Arkansas, just within the last couple of weeks, they passed a bill saying that all vision plans that includes not just vision plans, but medical plans that provide a comprehensive exam as part of their benefits have to be commensurate with Medicare reimbursement. That's a huge leap for a lot of those plans. And so we're really anxious to how that's gonna, how that's gonna roll out in Arkansas. And the testimony process of getting that law passed has unearthed some pretty discouraging opinions that the NAVCP has. That's the organization to which Vision Plan belongs. So that's their, their voice in the legislative arena. So it's interesting because we keep uncovering more and more information that's, you know, that we can work with and help doctors in the spirit of teaching someone to fish. Not only is AOA able to take care of those problems, but we're really pushing Vision Plans to have a more direct, easy connect for doctors to take care of these things themselves, you know, because that $3 million is just the tip of the iceberg. So in our conversations, you know, with CEOs of these plans, we're saying you've got to have an opportunity, something that's a quick, easy button way for them to dispute a claim denial or a clawback or something like that. So it's, it's a, it's a snowball, you know, with these laws changing, with doctors, you know, being more aware. I think that, I think that's a huge thing. I think many, many of our, of our doctors just don't know how much income they're given up because they're not, they don't have the time to pursue it. It's A challenge. So that's what we're helping out with.
- [12:20]
Eugene Shotsman
Well, and to stay on this topic for a few more minutes, I think I would be curious to hear about the process that it took to get that legislative win that you were just talking about in Arkansas. How many months, years, what, what was the effort? What were the resources that, what did you have to do to get that one win in that one state?
- [12:42]
Jackie Bowen
So the credit certainly goes to the doctors who are spearheading this in Arkansas. This win was relatively quick, actually. But these, you know, our scope expansion, those can take years of planning and constructing. But this particular vision plan win was swift. And I think that speaks to the obvious nature of the need for that kind of a bill. The lawmakers who are making this decision and voting on it get it. They say this is ridiculous. You're providing the same service to all these people. You're getting these radically different reimbursements for it. This is something that just needs to happen. It's the right thing to do.
- [13:22]
Eugene Shotsman
So do you think more states will follow?
- [13:25]
Steven Reed
Yeah, absolutely they will. Eugene. One thing along those same lines is that we learn a lot every time a state passes a vision plan deal. I mean, Texas passed a really good bill a few years back, but immediately, immediately the NABCP found loopholes in that. And so we learned from that and we learned to close those loopholes. And so Arkansas, to Jackie's point, did a really good job of bringing it home quickly. But in doing that with some model legislation that we, we helped to secure along the way.
- [13:59]
Eugene Shotsman
Yeah. So what's the kind of, what's the next frontier? And maybe actually before we talk about the next frontier, let's talk about some more Advocacy wins from 2024 over the course of the last year or so. What are other things? Just to give the audience a little bit of a bigger picture as to what's going on here.
- [14:19]
Steven Reed
Well, I can tell you one real quick. At the VA level, we're very, very proud of this. So at the va, optometry, optometrist have not been at the same pay level as your MDs, dos podiatrists and dentists. Back in 2004, they changed the pay scale for them and optometrists were left off. Well, we've been advocating that optometrists need to be at that level. I mean, obviously we are physician level providers. And just recently, as of January, a law was signed in Elizabeth Dole that was signed into the law that actually said that. Now they are. And so this is a huge win. For VA optometrist in that we have a lot of gaps in employment and optometrist, we need to have, you know, doctors coming into the system. We have a large group looking to retire. So it was a win at just the right time. It's also a very important thing for optometrists across this country country, because we continually fight. We call not a doctor bills and our opposition will come into the state and say, well, if you're not an MD or a da, you can't call yourself a physician. Well, we know that's not the case. We provide physician level care every day. Medicare calls us a physician. This is just another example here of where the government is leveling us with physicians and it helps us with ammunition and fighting these not a doctor bills as well as in our scope expansion efforts too. So it's a big win not only for VA optometrist, but optometrists across the country in our legislative efforts.
- [15:50]
Eugene Shotsman
That makes sense at how one, one layer kind of helps support a different layer. And then, you know, anytime anyone goes to challenge the profession, the things like this matter a lot. Even, you know, for those people who are listening who are not VA optometrists.
- [16:06]
Jackie Bowen
Well, and I want to elaborate a little bit more on the not a doctor bills. That's something that maybe not a lot of optometrists realize this is happening. But in eight states right now, there are bills that are being considered so that optometrists would not be called eye doctors, which historically, that's been a century's worth of an earned title that we have. So a lot of our wins are actually just good defensive moves.
- [16:37]
Eugene Shotsman
And for the folks in the program who are listening, why would someone want to not call optometrists not a doctor?
- [16:48]
Jackie Bowen
The opposition, we don't think they're very creative. These sorts of things cropped up 10 years ago, 20 years ago. Anytime optometry starts to move forward, particularly in the area of scope expansion, the opposition brings out these sorts of really ridiculous things. I think the general public would think it's ridiculous too. And because of our success in defeating all of these, I think that the lawmakers think so too. So it's, it's a distraction. It does tie up our resources, our time and money. You know, we have to, we have to spend a lot in order to make these defensive plays. And they know that. So it's a distraction technique and it's just kind of dirty pool, if you ask me.
- [17:33]
Eugene Shotsman
Well, and, and it sounds like, you know, it's, it's basically their technique against scope expansion of optometry. And it's something that puts, you know, makes the priority defense rather than offense.
- [17:46]
Steven Reed
Right.
- [17:47]
Eugene Shotsman
So let's talk about some scope expansion wins. You want to, you want to cite a few that, that have recently. That have recently gone through?
- [17:56]
Steven Reed
Yeah. Well, you may know already we have 12 laser states, as we. We call them, and those are very significant. So our very first laser state was many years ago is Oklahoma. And then we had a couple of other ones with Louisiana and Kentucky. But in the last few years, we've had a significant number who have actually passed the law. Mississippi is actually one of those, and Colorado, where Jackie's from, is one of those. And so we're very, very proud of that. I think right now we have 12, maybe 13, 14 states that are going for meaningful scope expansion. Of course, everything's meaningful. We typically mean by that, going for lasers. And what we're really trying to do is to be able to practice at the level that we're trained. We all know we're trained at the level across the country. But right now, I won't say who, but I'm pretty certain if I just had to get the old crystal ball out, that we may have about two this year that actually cross that line, as we're really looking forward to that. But that one thing we noticed with other expansion efforts along the way is that when you get past about, say, five or six states, then then really you cross the hurdle and we start seeing a lot more happen. So we would anticipate in the next five to 10 years to have quite a few states that actually cross that laser line, as we say.
- [19:18]
Eugene Shotsman
Yeah, and it's interesting because this follows a history, right, Jackie, there's, you know, before lasers, what was it that optometrists. That optometrists were not allowed to do that they can do now?
- [19:29]
Jackie Bowen
Oral medications, probably most recently before that, topical medications, and certainly before that, diagnostic drops, dilating drops. Each of these wins long before any of us were practicing were being fought. The parity that we have as physicians under Medicare and Medicaid was one in the mid-80s. So this has been the cross we bear as optometrists that we have to keep vigilant and stay on top of things. And our opposition is getting smarter, too. In one of the states, after they passed their scope expansion to include lasers and lesion removal went through the process, and it ended up as a potential ballot initiative where they were going to let the citizens of the state decide. And you can imagine the very Disturbing. Very untrue. Just slanderous advertising that was going on, trying to get the public to say optometrists shouldn't be able to wield a scalp sample and slice into your brain, you know, and all. So those sorts of efforts get really exciting. But we have. We have our cards and we have our ducks in a row. We know what we're doing, and we learn from other states. We learn from our mistakes, and that's what helps to build the momentum to get other states to be able to pass. You know, not every optometrist is going to choose to treat with lasers and lumps and bumps, but I think every optometrist should choose to support the opportunity for those who want to and need to do that. It's really about access. We know based on statistics, and we're continually getting information. And, you know this, Eugene. The need for eye care in this country over the next 10 years is expanding rapidly. That line is going straight up. The number of optometrists entering in the next 10 years is not as steep. The number of ophthalmologists entering the next 10 years is actually flatlined or even declining. So we've got a big problem ahead of us, and we need for optometrists to be able to take care of patients in our practices, because you shouldn't have to wait 18 months for a yag just because you don't have access to somebody with a laser.
- [21:44]
Eugene Shotsman
Well, and I'd like to caveat that it's a big problem, but it's also a big opportunity and a very exciting time to be in the profession. And it's also good that you've got an advocacy team if you're an optometrist that's working on your behalf. Now, I am actually super curious, and I think that, you know, I definitely. We're going to talk a little bit about the. The big initiatives you're trying to tackle right now. But before that, I kind of want to hear a little bit about. So, you know, one of you. So, Stephen, you're the president. Jackie, you're the President elect, and so you've been involved with the AOA for a long time. I kind of want to hear a little bit about your personal story, your background, and how did you get to where you are today, and why did you choose to volunteer all of this time? I mean, I imagine hundreds of hours of your time to support the profession in the way that you're describing right now. Jackie, you want to start?
- [22:42]
Jackie Bowen
Sure. I want to make note that I Became an optometrist because I was a pre med student and I did some investigation, realized that was not the direction I wanted to go into medical school. And a conversation with my optometrist in my hometown is what convinced me to. So even still, that is the most common reason people go into optometry. And I want to plug that and ask everyone to take every opportunity you can to encourage young patients who you see as potential optometrists to explore it. Because I talked about our numbers a little bit ago, we need more optometrists because of the great work that we're anticipating in next several years. I am a graduate of Southern California College of Optometry and met my husband while I was in California. And we got married while I was in school and I did a residency at Omni Eye Specialists and Ocular Disease Residency in Denver. And at the completion of that, I had one idea of what kind of practice I wanted to be in. But circumstances being what they are, my direction changed and I bought a private practice from a doctor who had just recently passed away in Greeley, which is north of Denver, about an hour. So I will say we didn't pick Greely. Greely picked us. And here, 32 years later, we have raised a couple of, you know, great sons. We experienced a loss of a child when she was 20 months old. And I was supported by not only my community here in Greeley, but the optometric community. And there are many, many other things that have happened throughout my life where I could have caved in and I might have caved in and just said, I'm not doing this. I gotta hang this up. There's no way I can do what I'm doing, much less add more by volunteering for the organization. But those doctors, my colleagues who supported me personally and professionally as an independent, are the ones that I saw really making changes and sacrificing, frankly, a lot to sure that our profession continues to grow and thrive. And it's really about answering a question to serve. I don't know about Steven, but I know that I never thought that I would be in this position. And it's a matter of just stair stepping. You know, if somebody asks you, hey, will you serve on this committee? Just say yes. You're never going to have the time or the money to be able to afford to volunteer. But if you don't, you're really going to be robbing not only yourself, but those around you of some really co opportunities. Each of my sons, who are now 25 and 27 years old who are not optometrists, but they have individually grown to love the profession. And they have said out loud, and I haven't recorded it, but I wish I would, but they've said, you know, Mom, I really respect what you do. I respect optometry. I really think that's important. And in my profession, I want to be that same kind of advocate and leader. And again, just if you're asked to do something, if you're asked to just serve in that, being a member and paying your dues, if that's all you can do right now, know that you are contributing to the. To the greater good.
- [26:01]
Eugene Shotsman
Yeah. And, you know, you started in the Colorado Optometric Association, I assume, right. That's where I still am and you're still. And you're still a member of the Colorado Optometric Association. And, you know, so how did it kind of. How did the transition between local and. We'll call it state advocacy and then. Or at this point, national advocacy. How's that transition?
- [26:26]
Jackie Bowen
Good question. So I served on the board of the Colorado Optometric association for seven years. And at the end of that time, or once you've been around a while, you start to get to meet people in other states, leaders in other states because of. For example, AoA has a President's Council meeting every year. We have a volunteer meeting, and everybody sees each other at optometry's meeting. So you develop relationships and, you know, then you're asked. So after I was finished with service in Colorado, I spent about 10 years as a volunteer in various AOA committees. And then one of the past presidents, who's a good friend of mine here in Colorado, started saying, hey, you know, I think you ought to consider running for the board. Oh, no, no, no, I don't. I can't do that. That's not me. I'm not political. You know, I can't take that time. But, you know, through a lot of, you know, encouragement from family and friends and prayer and contemplation, I decided to throw my hat into the. So again, it was just saying, okay, I'll try that. I'll step up, and if you believe in me, then I'll believe I can handle it, too. And that's kind of what I still am motivated by.
- [27:33]
Steven Reed
Yeah.
- [27:33]
Eugene Shotsman
And we'll hear a little bit more about your direction and agenda when you become president in June. But, Stephen, what about you? Where did you get your start, and how did you decide to start volunteering?
- [27:45]
Steven Reed
Yeah, well, yeah, I was thinking, as Jackie was Talking it's like, my goodness, it goes way back. I remember Eugene, when I was in school at Southern College of Optometry, and Mississippi at the time was going for SCOPE expansion. We were going for TPAs. And the first thing I remember was that I couldn't believe people were actually against us. I'm like, who would be against us taking care of patients? But I was very naive, to say the least. And I learned real quick that our opposition is a very greedy and fearful group. But that on the side. The second thing I noticed, and the most important thing was I was very impressed at this group of people, the Mississippi Optometric association, who are volunteers who work together, who said, we're going to make optometry better in Mississippi, we're going to take care of our patients. And so seeing the SCOPE battle, and we did win, by the way. And so when I graduated, I was able to come out and practice the things I was in school learning. But when I graduated, being a member of the MOA wasn't even a question. I'm like, well, yeah, I mean, why would I not want to be a member of such a group that cares for the profession? And so, like Jackie, I became a member of the state association, came back to McGee, Mississippi, which is where I'm sitting right now, small town, started my own practice and got to know a lot of people throughout the state. Of course, as Jackie says, it's a stair step that, that leads into, you know, the next, say, committee or the next whatever. And, and I particularly remember one time that I was, I was at one of these president councils last year. We were at optometry's meeting and I was walking along with our executive director. And she said, stephen, what do you, what do you want to do one day? And I said, well, I'm doing it right now. And she said, no, what do you want to do? Like past this point? And the only thing I could think of was, well, I want to keep growing and giving, so I want to be AOA precedent one day. And it stuck. And so from that time, that wasn't like the next year. I mean, I literally spent about 10 years, like Jackie said, trying to prepare to be that, because it's not like you, as she said, throw your hat in the ring. And all of a sudden you're, you're on the board. You got to work pretty hard for it. It's a very high achieving group of people. And so you've got to work to get on the board. But, but when I, when I did finally get on the board back in 2016. The one, the one mantra that I've had all along the way is that I remember throughout my entire volunteer journey getting to know better the members of Mississippi or whatever group I was involved in. But also remember those that were not involved, and those were usually the ones that would complain and they would say, well, why are you not doing this? And why are you not doing that? And I said, look, if I'm going to choose to do something rather than complain about it and be a part of the problem, I want to be part of the solution. And I think that's what's driven me all along the way, is being a part of the solution. And that's why I'm committed to being best AOA president I can be.
- [30:50]
Eugene Shotsman
That's awesome. I think those are great stories. So when we come back after the break, I'd like to talk a little bit about what the AOA has in store for the profession over the course of next year or a few years. And I want to zoom in on, you know, how you're actually going to be able to help practices over the course of the next over the course of the next few years.
- [31:09]
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- [32:03]
Eugene Shotsman
All right, we're back with the Power Hour. And I have with me doctors Jackie Bowen and Dr. Steven Reed, the president and the President elect of the aoa. And, you know, we're having a pretty interesting discussion. I think one of the things that, of course, we want to make relevant to the audience. We want to ask the question of what's the AOA doing for me right now and what are the key initiatives that you're focused on over the course of the next year? Jackie, since you're the President Elect, why don't you talk a little bit about what, what's going to happen when your term kicks off in June?
- [32:35]
Jackie Bowen
Of utmost importance, of course, are the things that we've been already working on. Our presidents continually work on the same strategy. Our strategic plan goes on over the course of years. And expanding contemporary optometry, as we call it, is a big priority. Contemporary optometry is the ability to practice at the top level of our training and our skill set. So that of course involves expanding scope in as many states as possible each year. The AoA board is committed, both financial and human resources, to help each state along in that process. And that's been a really successful process. I also am really looking forward to, because of what we know about the increase in eye care needs and the decline or stagnation of eye care providers, I think optometrists really need to focus on referring to each other. Our field is so broad, there's no way you can be an expert in everything, you know, vision therapy, myopia control, ocular disease, surgical intervention. And so because of that, we need to change our referral patterns to being a little bit more come and go. Right now we are used to referring a patient to an ophthalmologist and that is a one way street. They don't refer anything to us. But if I refer a myopia control candidate patient to my optometrist who does not treat glaucoma and I can build that relationship so that he sends his glaucoma patients to me and I refer my myopia control patients. That's beautiful, Synerg. That's what we should be doing and we should be increasing OD to OD referrals.
- [34:17]
Eugene Shotsman
Yeah, I love that focus. And Stephen, when you talked earlier about the kind of the two core missions of the or the two core pillars of the AoA mission, I think, you know, you talked a lot about serving the needs of the optometrist, but also about educating the public about. About exams. So I know that there is both a campaign and also a way to support optometrists in driving volume of the types of patients that they want to see. Right?
- [34:46]
Steven Reed
Yeah, there sure is. We have our I Deserve More campaign and it's taken on various forms throughout its time. We currently are focused more on the gamer community. There's a lot of people out there who are playing video games and even watching people play video games, which is odd to me, why you'd want to watch somebody on TV play a game. But anyway, all that to say they're spending all these hours playing this, and many of the other people in that group, being younger, they don't think about their eyes. And so we want to highlight the importance and the need to have a comprehensive eye examination to that group. We've also in the past focused on sports and particular athletes, and again, just various groups. But the whole message is the same in that you need to think about having a comprehensive eye examination by an AOA doctor of optometry on a yearly, yearly schedule. And it's not just part, as I mentioned before, not just part of getting your eyes checked, it's a part of your overall well being, your overall health care. And one of the things, one of the ways we measure that is through our doctor locator. And our doctor Locator is located on our website because the call to action is to go and click on that and find an AOA doctor near you so that you can schedule the examination. And we've actually had a tremendous success in that. It's into the millions and it keeps growing each year. And so we know that program is hitting the mark and being successful.
- [36:17]
Eugene Shotsman
Yeah. And I think that it's a oftentimes underestimated referral tool if it is, in fact driving patients into offices today. One of the things you know, and this may be one of the benefits, but one of the things I really want to talk about is exactly this. The benefits of membership. I mean, how many members do you have right now?
- [36:40]
Jackie Bowen
Roughly ballpark, we represent about 37,000 doctors. Our total membership is closing in on 50,000, including students and para optometrics.
- [36:51]
Eugene Shotsman
Perfect. So. And that's not a hundred percent of the profession, and I know that you'd like it to be closer to 100% of the profession. So for those people who are not necessarily members, or maybe not even active members, let's talk about the benefits of AoA membership and what you really get for it. In addition to being part of this advocacy community, which I think you've done a great job of describing, the value of being part of that.
- [37:18]
Steven Reed
Yeah, I'd be happy to speak to a few of those things. One of my favorite quotes is by John Maxwell, and he says, it's not about what you know, it's who you know, and it's so true. Because I think that as a way, members, we're part of this network. And by being part of a network and going to all these meetings like Jackie and I have attended, we get a chance to have so many good conversations sitting there and learning, okay, what do you, what do you do and what do we do? So I think the network would be number one. But as far as, you know, big benefits that we offer our members, one area is staff certification because Jackie mentioned before that we're seeing an increasing need for patient care and yet we're seeing not quite the same level of increase in optometry. And we take care of most of the patients in this country. And so it's going to be very, very important as we move forward that our staff is highly trained and they're able to take care of anything that we don't need to do as doctors so we can take care of these patients. So we offer, along those lines, a paracertification program. So we will help to train these, these paras and become certified so they can be more valuable for the doctors than they work with in their offices.
- [38:31]
Eugene Shotsman
And this is included in membership in general, right?
- [38:34]
Steven Reed
Yeah, yeah, it is. I mean, the, the paras are free to join as underneath their doctor. There are, there are levels of certification fees, like if you, you know, pay for this test, but certainly not by far cost prohibitive. And I say in my own office, because I'm a big advocate of this, it is so worth it because you get buy in the staff member, they're like, yeah, they feel more valuable on the team. And so, yeah, there's a little bit of cost on certification, but to reap the benefits from the para education and so forth. Now that's, that's, that's no cost to be a para member.
- [39:07]
Eugene Shotsman
Fantastic.
- [39:08]
Steven Reed
Yeah. One big area.
- [39:10]
Eugene Shotsman
Jackie, what about you? You want to add any other benefits that I think that, that, that optometrist should know about? Yeah.
- [39:19]
Jackie Bowen
Here's something kind of interesting that we know from inside and outside research that AOA member doctors report about a 13% higher income. And as Steven mentioned, that's because of a lot of resources, none the least of which is having trained staff. If your staff are higher functioning, you can see more patients in a day and work smarter. But also we're aware that there are many organizations out there where you can have networking, you can have practice tools to success, you can get training for your staff. But what the common denominator is on all those other organizations is that the thought leaders tend to be all AOA members. So although you may have experts in this area with this organization and that organization, when you come to an AOA event, all of them are there in one place. I think that's because those thought leaders, they're the smartest, the most successful doctors, the movers and shakers are all aware of the importance of being part of the solution, as Stephen mentioned earlier, not just letting others get it done. They all want to be part of the aoa and leaders across the board support the aoa. And ours is the organization where you're going to get all of that expertise in one bundle.
- [40:37]
Eugene Shotsman
And I want to highlight that one more time. So you said that on average an AOA member doctor reports having 13% higher income than a non member doctor. And that's a really interesting statistic. And I heard you say the community, the thought leadership and certainly the training resources are key reasons why that might be anything else you can think of that could potentially be driving that success.
- [41:05]
Steven Reed
I can tell you one thing real quick on the 13% more, let's look at Covid for example. Okay. When all that came up on Covid and ppp, well, guess what, Our doctors got in there, figured this thing out and we were able to quickly get a bit. Matter of fact, if it hadn't been for aoa, we would not have even been a part of that program. So that's number one. But the fact that we were LinkedIn from AoA perspective as members, we were able to get on webinars and listen and see. Okay, well how do we access these resources? And it made a tremendous difference for just something like that.
- [41:39]
Eugene Shotsman
Yeah. And you know, I think that there's value to membership. But I'm going to ask you maybe one last question that might help people understand this is if the AOA ceased to exist and let's say the AOA ceased to exist. I don't know. Pick a number. 15 years ago, 2010. So all of us would be in our careers today without the AoA. What would the world be like and what would be different about the world in which we practice today?
- [42:09]
Jackie Bowen
Jackie, you've hit on my dream project, my It's a Wonderful Life documentary for optometry. I honestly believe we would probably not be a doctor led organization. We would have been absorbed under the umbrella of medicine. We might be doing expanded procedures because they know that we are skilled enough, but we would be doing it under their auspices so that they can take advantage of the income that is derived from that. I don't think we would have the Privileges that we have in states. I think we would be glorified technicians inside ophthalmology practices or just solely refractionists outside their practices. What do you think, Stephen?
- [42:56]
Steven Reed
I was thinking the same thing, Jackie. I don't know if I can add to that. Furthermore, I think if today we cease to exist, if all of a sudden tomorrow AOA is gone, I don't think our profession would last more than a year. That's just my two cents on that, because we're really. And I'm not saying that. Oh, look how important Jackie and Steven are. I'm just saying that our profession, we've got to have an arm that advocates for us, and that's what we do. And so we see the opposition out there. We've mentioned that a few times in here. And they would love nothing more than for us just to go away.
- [43:27]
Eugene Shotsman
And when you say the profession won't last more than a year, clarify that a little bit more. If it goes away today, what's 2027 look like? What are, what are. What's the optometrist who's sitting there in, in their, in their office today doing two years from today?
- [43:43]
Steven Reed
Yeah. Well, I mean, the first thing I would think is we start seeing an unwinding of escope expansion laws across the country. So our privileges would start decreasing, which would mean exactly like Jackie said, then our. Our choice of where to practice would be either as a refractionist. And of course, refractions are important as part of what we do. But we should be doing a whole lot more than that to take care of patients, you know, or, you know, we would be. I think your term, Jackie, glorified tech would be about the vet. Yeah, good example of that. So that's what would happen.
- [44:11]
Eugene Shotsman
And what about reimbursements?
- [44:14]
Jackie Bowen
We wouldn't be seeing any of that. We'd be hourly employees.
- [44:20]
Steven Reed
Of course, third party would take over and do what they want to do because nobody's pushing back on that. We don't see ophthalmology fighting against vision medical plans much. You know, it's us doing the work.
- [44:31]
Eugene Shotsman
Yeah. So I guess, you know, aoa, I think to kind of conclude here, the AOA is doing important work that impacts every practicing optometrist and in many cases their staff. How do people get involved? And how do people get more involved if they're already members? How do they get more involved? And what's your recommendation to people listening?
- [44:55]
Jackie Bowen
I would urge anyone to, if you're not a member, go to aoa.org or more specifically your state organization website. It's easy to join and it's important to join. So please, even if all you do is become a member, that is a huge step and we thank you for making that decision. But contacting your state executive director, your state president leadership, and say, I want to get involved, I want to do something more, I promise you there's going to be something that they'll have for you to jump into.
- [45:27]
Eugene Shotsman
Yeah, I think this has been an important conversation. It's probably one of the, one of many that we'll have as the AOA continues to make progress and continues to make an impact on the profession. Certainly a pleasure having both of you on the show. Dr. Jeff, Jackie Bowen, Dr. Steven Reed, thank you for being on the Power Hour with me today.
- [45:47]
Steven Reed
Oh, thank you for letting us be here.
- [45:48]
Jackie Bowen
Thanks so much, Eugene.
- [45:50]
Eugene Shotsman
Thanks for listening to today's Power Hour episode. The Power Hour is actually owned by the Power Practice. Power Practice is a premier consulting group who helps practices achieve freedom of time, confidently solve practice issues and grow their practices. They do this by having coaches and OD consultants, people who have actually done it, been there, and they're ready to help. You want to learn more, go to powerpractice.com there's a bunch of free tools there. You can also get a whole bunch of information and decide whether it's right for your practice. Again, if you're looking for more time, you're looking to solve complex practice issues or grow the Power Practice might be right for you, go to powerpractice.com to find out more.