How Does Optometry Want to Fit Into the New Healthcare Landscape?

I just finished participating in a meeting of the Association of Schools and Colleges of Optometry.  That group is composed of all the Deans and Presidents of the nations optometry schools with representation from our neighbors in Canada.  I had the distinct honor to lead a discussion on how optometry, as a profession, will prepare our new graduates to work in the new healthcare landscape that has been developed by the Affordable Care Act.  Along with that I also asked the group to explore how to build the foundation for the expansion of clinical privileges to include the diagnosis and treatment of such pervasive diseases as diabetes, hypertension, hyperlipidemia and other prevalent metabolic disorders that often beckon the doors of optometric practice.  The discussion on expanding the scope of practice was spirited, to say the least. There was consensus that we, as educators, need to do a much better job of preparing our graduates to succeed under the new healthcare landscape to include understanding the lexicon of Accountable Care Organizations, Medical Homes and other payor models.  I think we agreed to all work together to develop a consolidated curriculum that will address this in the near future.  I'm committed to having Salus take the lead on this.  

There was much more discussion and debate around the scope of practice expansion.  The Affordable Care Act will result in a significant shortage of primary care providers in the country through the foreseeable future. Someone is going to need to fill that void to see those diabetics, hypertensives and others needing care.  While physician assistants, nurses and possibly others will certainly help to fill that void, optometrists are extremely well positioned to provide the necessary care.   Many diabetics and hypertensive patients are often diagnosed or referred for definitive diagnosis following a routine eye exam.  With additional didactic and clinical training, optometrists can obtain the necessary skills to care for those patients.  While much work still needs to be done both academically and statutorily, I believe this is the direction that optometry needs to take.  A little over 30 years ago optometry obtained diagnostic and therapeutic privileges.  For the benefit of the public health, economics and the patients optometrists care for, it's now time for the profession to take the next evolutional step towards the diagnosis and management of the common diseases aforementioned.  Appropriately, there will be much debate over this, but in the end, the profession needs to decide what direction to take as we enter into this new landscape of healthcare delivery.