Part of the solution: Optometry groups join AOA in submitting actionable solutions for workforce shortages

April 5, 2023
The presidents of the AOA, ASCO and AOSA jointly respond to March 2 call from Sen. Bernie Sanders, chair of the Senate Committee on Health, Education, Labor and Pensions (HELP), and ranking member Sen. Bill Cassidy, M.D., for AOA and its partners to give input on “the root causes of the current health care workforce shortage and potential ways to address it.” Their feedback will be used to identify bipartisan solutions for legislation in the future, the senators say.
People blocks with magnifying glass

In a joint letter, leaders of the AOA, the Association of Schools and Colleges of Optometry (ASCO) and the American Optometric Student Association (AOSA) called out barriers to addressing the nation’s health care workforce shortfall and offered seven concrete solutions to remedy the situation.

Namely, they called for inclusion of optometry in programs that track, analyze and report provider shortages, and, further, address student debt under programs run by the Health Resources and Services Administration (HRSA), which among other things seeks to support programs that increase equitable access to health care and grow and diversify the health care workforce.

Major barriers “to increasing the number of doctors of optometry is the current omission of optometry in the Health Resources and Services Administration (HRSA) and the high cost of education,” they wrote in a March 20 letter to the Senate committee.

The letter was co-signed by AOA President Ronald L. Benner, O.D., ASCO’s President Melissa Trego, O.D., Ph.D., and AOSA’s then-President Easy Anyama. (The newly elected AOSA president is Emily Benson.)

“As the voice of the profession, the AOA with our student affiliate the AOSA, speak to both the present and future of optometric practice,” Dr. Benner says of the jointly submitted feedback. “By joining with ASCO, we are able to help guide solutions that will be effective in attracting the best and brightest students and then helping them find careers across the U.S. in rural and urban areas that show a workforce shortage.

Adds Anyama: “I felt it was crucial for us to join in this effort because it directly addresses the challenges facing students and the profession as a whole. The AOSA is committed to advocating for the future of optometry, and this letter offers actionable solutions to address the increasing demand for eye care services we are experiencing or soon will experience.”

Essential to eye care: doctors of optometry

In their extended feedback, the three optometric bodies elucidated the essential role doctors of optometry have in the nation’s health and why the size of their workforce matters.

Not only are doctors of optometry primary health care providers who have extensive training to examine, diagnose, treat and manage ocular disorders, diseases and injuries, but they also detect systemic diseases with ocular manifestations—including diabetes, hypertension, cardiovascular disease, autoimmune diseases and neurologic disease.

“The AOA and its members serve the needs of the public and health professionals through the provision of evidence-based clinical practice guidelines that promote prevention, identification, treatment, and management strategies for eye and vision conditions/diseases to improve the nation’s health,” the leaders say.

“As the U.S. population grows and ages, the demand for vision care is increasing,” they add. “More doctors of optometry are needed to diagnose and treat these ocular disorders and diseases to increase the overall quality of life of our population.”

Access to this essential eye and vision care has consequences for public health—without it, Americans can experience a decline in their quality of daily living. Eye and vision disorders are linked to loss of mobility and independence, can impact employment status and can lead to reduced social engagement and depression.

There are economic and social consequences for these life events as the U.S. population continues to age, say the leaders who cited the millions of Americans who are legally blind and have visual impairments, as well as the numbers of people with uncorrected refractive errors.

“It is estimated that at least 40% of vision loss in the United States is either preventable or treatable with timely intervention, yet many people are undiagnosed and untreated,” they say.

Care, as provided by doctors of optometry, matters.

“Detection of systemic diseases through a comprehensive eye and vision examination can lead to earlier treatment resulting in better patient care, avoidance of complications, and reduced health care costs,” they say.

Growing demand for doctors of optometry

As the U.S. population ages, the demand for doctors of optometry is growing, the leaders’ letter points out. The Bureau of Labor Statistics has forecast employment of optometrists to grow by 10% between 2021 and 2031—“faster than the average for all occupations.”

“Because vision problems tend to occur more frequently later in life, an aging population will lead to demand for optometrists,” says the Bureau’s Job Outlook, which also notes the increasing prevalence of myopia, digital eyestrain and diabetes as factors impacting demand.

“With diabetes on the rise, optometrists will be needed to monitor, treat and refer these patients,” the outlook adds.

AOA offers solutions

With demand for eye care by doctors of optometry well established, they presented recommendations to ensure that Americans have access to the eye care they need. Solutions are:

  • Re-including optometry in HRSA health profession shortage area designations. HRSA tracks health care provider shortages in the U.S., but only data for “primary care,” dental health and mental health shortage areas are analyzed and reported. Data on optometry, which was once collected for these calculations, is no longer tracked. “The inevitable increase in demand for eye care with the aging of the U.S. population increases the urgency with which the government needs to track eye care access,” they say. “Because optometric care is primary, we believe that HRSA’s shortage area data analysis should be expanded to include optometry and information should be made publicly available.”
  • Expanding grants to states to support optometry workforce activities. HRSA’s grants help states develop and implement innovative programs to address workforce needs in designated health profession shortage areas. Optometry is not currently included. “Given the expected increased demand for eye care, federal support for state efforts to address optometry workforce needs must be developed,” they say.
  • Re-including doctors of optometry in the National Health Service Corps (NHSC) program. The NHSC is the flagship health workforce program at HRSA. Doctors of optometry are currently excluded from eligibility for loan repayment and scholarships programs, despite longstanding bipartisan and bicameral support for their inclusion. In exchange for scholarships, recipients must serve in shortage areas. Says Dr. Benner: “Eye care is needed all across America. Inclusion in the NHSC brought many optometrists to underserved areas back when we were included in the program—many of whom stayed and have enjoyed great careers and lives in those communities. Having our profession again being able to participate and be recognized as the essential providers we are is something we can all agree on. Many new graduates come from these underserved areas and would love to return to them to practice, but without being able to participate in these programs designed to assist practices in workforce shortage areas many new graduates will not be able to realize their dream.”

Says Anyama: “Student debt is a significant burden for many students in optometry. The staggering debt burden, which currently averages around $200,000 per student, may also dissuade many talented individuals from joining the profession. By implementing the solutions outlined in the letter, such as reducing student debt and expanding loan repayment programs, we can make optometry a more accessible career path and, in turn, help address the growing public demand for eye care services.”

  • Make doctors of optometry eligible for the State Loan Repayment Program (SLRP): Under the program, HRSA provides grants to states to fund their own loan repayment. Primary medical, mental/behavioral and dental clinicians receive awards through SLRP-funded programs to pay off student debt in exchange for working in areas with provider shortages. Say the co-signers: “Vision and eye care are important components of primary care and inclusion of doctors of optometry in the State Loan Repayment Program (SLRP) would help to encourage primary eye care providers to practice in underserved communities, to increase access to needed care for patients, and to leverage current federal programs and efforts to support even more students and borrowers and, in turn, the patients across the country that they serve.”
  • Enact the Indian Health Service Health Professions Tax Fairness Act. This key legislation would allow optometrists and others participating in the Indian Health Service Loan Repayment Program to exclude interest and principal payments from their federal income taxes, as well as certain benefits received by those in the Indian Health Professions Scholarships Program.
  • Promote greater diversity in optometry. AOA surveys show that optometry student debt among underrepresented groups in optometry schools is “significant.” Among ways to increase diversity in optometry, they say, is to support diversity efforts at America’s schools and colleges of optometry, increase funding for career and technical training programs at community colleges and trade schools for eye and vision care technicians, and fund and support programs at elementary and secondary schools in underserved or diverse communities to attract young people to the profession early.
  • Enact commonsense legislation to help lower student debt burden. The AOA supports passage of the Protecting Our Students by Terminating Graduate Rates that Add to Debt Act, which would reinstate eligibility for graduate and professional students with financial need to receive Direct Subsidized Stafford Loans. Only undergraduate students are eligible now for those loans. In addition, the AOA supports passage of the Student Loan Refinancing and Recalculation Act which would allow borrowers to refinance their federal student loans when interest rates are lower, while eliminating loan origination fees and allowing residents to defer payments until after completing their residency programs; and also the Student Loan Interest Deduction Act, which would double the student loan interest deduction (from $2,500 to $5,000) and eliminate the income limits that prevent those with higher incomes from reaping the benefit.

Support the AOA’s advocacy

Help the AOA continue its advocacy on behalf of optometry students and new graduates by getting involved and helping to build momentum. Here’s how:

  • Visit the AOA Action Center.Learn more about the NHSC issue and other federal priorities for optometry. Or text “NHSC” to 855.465.5124 to encourage optometry’s reinstatement in the NHSC.
  • Join optometry's advocates for AOA on Capitol Hill. The AOA's single-largest annual advocacy experience, AOA on Capitol Hill, will occur in conjunction with Optometry's Meeting®, June 21-24, in Washington, D.C. AOA on Capitol Hill participation is open to advocacy-minded AOA doctors and optometry students with sessions intended to prepare attendees to join the ongoing advocacy fight for the profession's future. Registration for both Optometry's Meeting and AOA on Capitol Hill is required to participate.
  • Become an AOA-PAC investor.This is one of the easiest, most effective ways to help make an impact in the AOA’s ongoing advocacy efforts. Use your eight-digit, AOA membership ID number and log in from your computer to make an immediate investment* to support the profession.

*Contributions to the AOA-PAC are for political purposes and are not tax deductible. Only AOA members and other eligible persons may contribute. Contributions will be screened and those from non-eligible persons will be returned. You have the right to refuse to contribute without fear of reprisal. You will not be advantaged or disadvantaged because of how much you give or because you do not give.

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