2019 Eyecare Insights with Matt Geller

Throughout the year I bookmark and curate the biggest headlines that I believe have the largest impact on eyecare. Here is my summary that you can quickly digest and reflect on.

What better way to close out 2019 than to reflect on the important events that affected optometry!

2019 was a strong year for optometric consolidation. We saw the acquisition of Visionworks by VSP (over 700 locations), the final approval of the EssilorLuxottica merger along with their acquisition of GrandVision, and the EyeCare Partners acquisition of Nationwide Vision (89 locations). We also saw Goldman Sachs buy Capital Vision Services, which operates 575 optometry practices under the MyEyeDr brand. Yet at the same time, we also saw Luxottica part ways with 115 Sears locations. We saw Takeda acquire Shire for $62 Billion and then not long after, Novartis acquire Xiidra for $5.3 Billion. Similarly, we saw AbbVie acquire Allergan for $63 Billion.

Medical diagnostic innovation was extremely strong, with notable product releases such as the Cirrus 6000 OCT by ZEISS, the Optos Silverstone, and Topcon’s Maestro Unlimited. On the pharmaceutical side, we saw FDA approval for Rocklatan, a Rho kinase inhibitor and a prostaglandin analogue used to treat glaucoma—not to mention FDA approval for Novartis’s BEOVU, offering wet AMD patients new hope.

When it comes to contact lenses, I think J&J’s Acuvue Oasys with Transitions really took the innovation crown, followed by Coopervision’s MiSight lens to slow the progression of myopia. We saw the closure of J&J’s Sightbox contact lens service and the creation of Warby Parker’s Scout contact lens.

Advocacy certainly had its share of wins, most notably with the shutdown of the online vision screening test from Visibly (formerly Opternative) by the FDA, all thanks to the AOA and its members. At the same time, we need to be careful. Only 3 weeks ago, 1800 Contacts announced the acquisition of 6over6 Vision, another online vision screening test—whack-a-mole, right?

Also, in some miscellaneous news check out the WHO report on vision, the Class Action Settlement against NBEO, ASCO’s Optometry Gives Me Life campaign, the migration of NewGradOptometry into CovalentCareers, and our 2019 optometrist report—a comprehensive look at the industry today.

Catch you in 2020!

As you read this, I am traveling abroad in Vietnam, which is just one of the countries where the Brien Holden Vision Institute (BHVI) is working to train eyecare professionals. According to the 2019 WHO report, there is a dire need to get local communities trained in order to support the 2.2 billion people with a vision impairment—1 billion of which could have been prevented.

Luckily, there is no shortage of efforts to chip away at the problem—whether it’s BHVI training up thousands of eyecare professionals or EssilorLuxottica quantifying the $14B cost to eradicate poor vision by 2050, large-scale mission trips like OneSight, or smaller ones like iCareForIndia by Aaron Lech, OD.

What’s interesting to me is the opportunity for telehealth solutions worldwide. As ODs, myself included, we tend to fear telehealth because of the thought that it will replace us. But aren’t these digitization solutions needed in order to help solve a crisis on this scale? The WHO report mentions telehealth over a dozen times, and the EssilorLuxottica report calls out that a $0.7 billion investment in low-cost, digital or automated screening tools would be needed to significantly accelerate the scale-up of digitization efforts, existing and new.

Telehealth solutions like DigitalOptometrics are gaining traction in areas where access to an OD is difficult. EyecareLive is helping to keep patients connected to their eyecare providers after the in-office exam. Many companies are leveraging the power of smartphones to auto-refract and capture retinal photos—thereby demonetizing the cost of diagnostics.

It’s just a matter of time before telehealth solutions take root and flourish. As ODs, we understand the benefits that telehealth can have for millions of patients worldwide, and it’s up to us to ensure that this modality does not lower the standard of care for our communities, local and global.

This is a new topic for me. What do you think?

I was recently looking at optometrist salaries as a signal of how our profession is changing. The report we released this month shows, among other things, OD starting salary graphed by graduation year. That graph tells us that over the last 9 years, the average OD starting salary increased 36%—from $73k in 2000 to $99.3k in 2019. Additionally, we see that 71.7% of ODs expect their salary to further increase in 2020.

Why do salaries increase? To get the full picture would require a trained macroeconomist, but I will focus on US Inflation as measured by the Consumer Price Index (CPI).

CPI is a measure of the average change over time in the prices paid by consumers for goods and services and therefore is a measure of inflation. From 2000 to 2019 the CPI was 2.11%. If salaries don’t increase by at least the CPI rate each year, then employees will have a net loss in purchasing power year-over-year.

But here is the problem—if you calculate a 2.11% compounding growth rate of OD salaries from 2000 to 2019, starting salaries should be at $108,547, not $99,300. Over this 19-year period, the total percentage change in inflation was 44% but the change in OD salaries was only 36%. We know that corporate optometry and private equity pay roughly 12.3% higher than private practice, so corporate OD salaries are on par with the CPI rate.

The Fed shows that the average month-over-month wage growth rate in healthcare was 3.3% over the same period of time, so optometry seems to be behind the rest of healthcare at 2.03%. At the same time, the demand for ODs is rising due to aging baby boomers, market consolidation, and growth. This has created a short supply of ODs, which should cause OD salaries to rise faster than the CPI rate. The data isn’t perfect and it’s presented as a nationwide average, but it’s surely an interesting trend to observe!

Starting OD salaries should be at least $110,837 in 2020 if they are to keep up with inflation. We’ll see what our next report says this time next year!

This month, ASCO launched a new campaign to attract pre-med students to optometry school. I dug into ASCO's data reports and discovered that in 2018 there were 2,527 applicants to optometry school and 1,846 seats. This means a 74% acceptance rate and an 8% decrease compared to the last application cycle. Furthermore, the total number of graduates at the schools and colleges of optometry decreased by 0.5% (8 grads) in the latest report from OptomCAS.

Contrast this to dentistry, which had 11,873 applicants and 6,122 seats, which means a 52% acceptance rate and an intensely competitive process.

Darwin tells us that competition drives natural selection which leads to a healthier and stronger organism. Does it then follow that less competition in optometry school admissions leads to a less-healthy, less-strong optometric profession?

A friend emailed me this month asking for help hiring an OD for his practice. When we got to talking, I was surprised to hear that he was unaware of how hard it is to hire ODs in today’s labor market. The common thought is that “there are too many optometry schools and too many practices,” but this is an illusion. In reality, there is a whopping 9,000 full-time equivalent shortage.

This aligns with what my company, CovalentCareers, is finding. Many of our clients came to us after searching for ODs for 4-12 months, desperate for a solution. In theory, if it’s difficult to hire, it should be easy to find a job, right? Well, we conducted a survey in Dec 2018 that validated this exactly. We surveyed 669 new grads who rated their average difficulty to find a job at 3.5 of 10, with 51% finding a job before graduation and 49% finding a job within 3.5 weeks after graduation—that sounds pretty easy to find a job if you ask me!

If you’re having trouble hiring or want to pick my brain about what’s working for today’s practices, don’t hesitate to reach out.