‘You can and will rise above’

PHOTOGRAPHY BY CATE BROWN

“It is imperative that optometrists remain fully engaged and determine their future,” says Stephen Montaquila, O.D. “Whether that be advocating for inclusion in health plans or expanding scope of practice to ensure patients have access to the latest treatments and technologies.” 

Dr. Montaquila is a longtime advocate for optometry, including through his service as a past chair of the AOA’s Third Party Executive Committee and as a current member of the AOA Federal Relations Committee.  

In a Q&A with AOA Focus, he explains why all members should join him—and how to get started. 

Why do you advocate for optometry? 

First and foremost, it is about providing the best possible care for our patients and eliminating barriers to them receiving that care. To do that, we must be able to practice to the highest level of education and training and be able to participate with [patients’] health insurance plans. I was fortunate to work closely with past AOA President David W. Ferris, O.D., who dedicated his life and career to advocacy for the profession. He taught me firsthand the importance and impact of advocacy. We have a duty and obligation to pay it forward, to ensure patients continue to have access to high-quality eye health and vision care delivered by current and future optometrists. 

What is the biggest challenge facing optometry in 2024?  

State-level “not-a-doctor” bills, federal-level challenges to optometric scope of practice in the VA health system, Medicare pay cuts, vision plans continuing to undermine our professional judgment and ability to manage our practices and our patients, large profit-driven corporations introducing state-level legislation to restrain trade within our practices. ... With all of that said, it seems to me the biggest challenge is in developing the next generation of leaders and advocates. Today’s new graduates are not given the opportunity to learn the history of our profession, where we came from and how we got here. They graduate, become fully licensed and care for patients. They were not there to fight the battles of years past, but in my opinion, understanding those battles is key for them to understand the value and need for advocacy for optometry. 

From your perspective as a past chair of the AOA Third Party Center Executive Committee, what can all members do to fight back against vision plan abuses? 

One of my mentors, Chuck Brownlow, O.D., was often quoted as saying, “I cannot tell you to stop taking that terrible plan.” Federal law prohibits doctors from banding together to fight these kinds of abuses, and colleagues cannot advise others about what plans to take and not to take. As chair of the AOA Third Party Center Executive Committee, my team worked tirelessly to advocate for better conditions with these plans. We educated them as to how their policies were detrimental to our patients and practices, and we were successful in getting some positive changes. However, it is imperative that doctors carefully analyze each and every plan they contract with and ensure they agree with the policies of these plans. Doctors should only accept a plan that makes good business sense for them.  

We have also seen many states pass laws that directly target some of these abuses. These laws serve as a foundation for doctors to be able to advocate for themselves and their own practices by making some of the practices of these large, vertically integrated companies illegal at the state level. The AOA is also working tirelessly to advance the DOC Access Act, which would address these abuses on the federal level, and, when this becomes law, it will provide further protections. 

What is the best piece of advice you can give to colleagues to be a successful advocate? 

Understand that you are the expert in the field. Begin by fully understanding the issues, including the points and counterpoints.  

• Develop a solid game plan along with your other colleagues.  
• Nurture relationships with key opinion leaders and key legislators or health plan decision-makers.  
• Serve as a subject matter expert so that they know and trust that you are providing them with verifiable, actionable information on the topic.  
• Also, listen and learn. Listen to the legislator, policymaker or health plan decision-maker and ensure you fully understand their concerns, and then prepare a sound and convincing reply to each of their points.  

It is important to know ahead of time that there always will be others who will criticize and challenge our position; but know that you can and will rise above that.