Friday, March 14, 2014

Passion for what you love - M. Boltz

Passion. The Merriam-Webster Dictionary defines passion as “a strong feeling of enthusiasm or excitement for something or about doing something.” I think my family and closest friends would agree that, in general, I am a passionate person. Those who know me best will tell you that the things I’m most passionate about are travel (especially international destinations I’ve visited or hope to visit, like the city of Chicago and the Hawaiian islands); being a “foodie” (trying new restaurants and seeking out various ethnic cuisines); our recently-rescued kitten named Coco; and most importantly, pediatric optometry. 

I became a pediatric optometrist for many different reasons. The main one involved my early discovery of enjoying working with children. In fact, my freshman year of college I was an elementary education major! I later switched to biology/pre-med due to my equally-significant interest in pursuing a career in the medical field. Ironically, my Lebanon Valley College psychology professor was good friends with a local optometrist, Dr. James Bouquet, and knew a bit about developmental optometry and vision therapy. A psychology research project he helped me design involved subjects doing convergence exercises with an antique stereoscope to investigate its use in decreasing near point fatigue. Planets aligned and interests were meshed, thus solidifying my desire to apply to optometry school the following year. While at PCO, I joined the COVD student organization and eventually went on to become the national student liaison to the COVD Board of Directors. Not surprisingly, my interests drove me to complete a pediatric optometry and binocular vision residency at Illinois College of Optometry. 

After almost 17 years of practice, my passion for pediatric optometry is unwavering. I still get excited to see the smiling faces of the children under my care, to make a life-changing diagnosis of accommodative esotropia and prescribe a first pair of +6.00 glasses, and to be able to reassure a teenager suffering from daily headaches due to convergence insufficiency that a program of vision therapy will provide relief to his or her problem. Beyond this day-to-day practice, I also love sharing my passion with fellow optometrists and medical professionals by speaking locally and nationally about general pediatric vision care and pediatric low vision. 

One of the primary goals I have for the POA in 2014 is to promote children’s vision. The timing could not be more perfect, matching the rollout of the Affordable Care Act with the pediatric essential benefit in place. The AOA, as a result of your membership dues, fought diligently to make this pediatric essential benefit a reality, a prime example of how the AOA makes sure that optometry is not forgotten or left behind in the legislative or third party arena. With this coverage for comprehensive eye exams, medical visits and materials for ages 0-18 years, it is very likely that most of us will see an increased number of children in our practices over the next year.

To this end, I have unofficially named 2014 “The Year of the Child.” Watch for the re-introduction of the Kids Welcome Here ® Program – a public education and patient recruitment program that is highly recognized around the country. We especially hope to highlight this program at Optometry’s Meeting in Philadelphia. Plans are also being finalized for a six-hour pediatric continuing education program on November 23 in Hershey, featuring a nationally-recognized pediatric optometrist from the ICO, well-respected members of our Pediatric Vision Care Committee (PVCC), and even a developmental pediatrician discussing autism spectrum disorders (how to work best with these children in our exam chairs and associated vision concerns). I am also working closely with the AOA in facilitating an InfantSEE event to be held at PCO. This program has been making its way around the country at several schools of optometry and features both a student program with motivational speaker Tom Sullivan and a COPE-approved continuing education program for optometrists. Lastly, the PVCC will be working towards the long-anticipated goal of a Children’s Vision Day at the Capitol.  We are fortunate that the PVCC chairperson, Dr. James Spangler, has a solid relationship with a local state representative who we hope to recruit for support of this project. 

The noted speaker and author on leadership John Maxwell said it best: “A leader’s courage to fulfill his vision comes from passion, not position.” It is my vision that over the next year, through increased exposure to and education about pediatric optometry, you, too, will come to share a bit of my passion for taking care of our youngest and most precious patients.  

For the love of children,

Marianne E. Boltz, O.D., F.A.A.O.
Pennsylvania Optometric Association

Thursday, January 23, 2014

New year; old resolutions

The clock strikes twelve on New Year’s Eve - 2014 is here! The crystal ball just dropped in Times Square, and a large Hershey’s kiss just descended in Hershey. Auld Lang Syne lyrics echo from the TV, while fireworks pierce the quiet and light up the sky of downtown Hershey. I begin to reminisce about the highlights of 2013 and think about what may lay ahead for 2014. Resolutions ... ugh, the obligatory New Year resolutions … for me and for the Pennsylvania Optometric Association.

Personally, my New Year resolutions don’t change too much year to year. They usually involve losing weight (20 pounds would be really great!) and getting to work a bit earlier each day (which means not hitting the snooze alarm each morning at least three times). But, alas, I’ve come to the realization as to why these same issues plague me each year: I need to address the big picture. For instance, rather than focusing on just what my scale says each morning or what clothes fit me, realize that the more important issue is my general health – providing for a good quality of life now and for the future. Also, I must realize how lucky I am to have a career as a pediatric optometrist that gives me so much personal satisfaction, and a position at Penn State Hershey Eye Center that provides me so many unique patient care and teaching opportunities. So what’s the big deal about getting a half-hour less sleep in the morning?

Likewise, the POA each year has resolutions that continue to challenge the organization. Two of these repetitive goals are increasing active membership numbers and increasing member contributions to both POPAC and AOA-PAC. It is my hope that more Pennsylvania optometrists will, as I did, step back and look at the big picture in regards to these issues. I want the statewide non-members to look past the cost of yearly dues and realize the value of the numerous tangible and intangible benefits of membership in the POA and AOA. I also hope that you, as POA members, will be a bit more generous with PAC donations, realizing how extremely important they are to the future of optometry in this state and nationwide. Contributing to one or the other is also not acceptable - we need to support efforts of both PACs to move the profession forward locally and throughout the country. Optometry is a legislated profession, and maintaining the practice privileges we have today and any hope for scope of practice expansion in the future bluntly costs money. I wish I could say that we can advance our profession just because what we want is right and best for our patients; but that is, sadly, just not enough. It is one compelling lesson I learned over the last six years as a POA Board member. 

I am both humbled and excited by the honor of representing each of you as the 2014 POA president. We have much to look forward to this year! For example, we are planning to roll out several pediatric initiatives (making 2014 the unofficial “Year of the Child”) and have the privilege of hosting the AOA Optometry’s Meeting in Philadelphia this June – we hope to see you there. Dr. Rich Christoph (POA president-elect) and I represented Pennsylvania earlier this month at the AOA President’s Council in San Antonio. Stay posted for the next issue of the Keystoner for our report on the hot topics and highlights of this interesting conference – it’s always a unique opportunity to learn what is happening with the profession of optometry around the country. 

In the meantime, I wish you and your family a happy, healthy New Year. Good luck making those resolutions ... just don’t forget to make the POA a part of them!

Marianne E. Boltz, O.D., F.A.A.O.
Pennsylvania Optometric Association

Wednesday, December 18, 2013

POA and AOA at work for you: 2013 and beyond

As I prepare my last Presidential Editorial, I’m haunted by the lyrics of an early Billy Joel song: “Well, so here I am at the end of the road, where do I go from here? I always figured it would be like this, still nothin’ seems to be quite clear.”

Okay, the relevance of the lyrics: Has there ever been a time with more ambiguity with health care and our government? The Affordable Care Act (a.k.a. Obamacare) passed as a law and its constitutionality verified by a Supreme Court decision, yet some legislators attempted to shut down our democratic process in defiance – somewhat akin to secession – which racked up an estimated $24 billion tab.

A recent AP survey reported an approval rating of our Congress at 5%; a further decline from my Spring editorial on sequestration when there was a 14-18% approval rating of Congress. Yet, our Congress seems to be either oblivious or immune to this expressed disapproval rating. Could anyone run a business that only pleased or appeased 5% of their clients/customers? “Nothin’ seems to be quite clear.”

The Affordable Care Act is moving ahead and the insurance exchanges are finally open for business (though still with problems) after a decidedly rocky start despite approximately $400 million spent on developing the programming. To access the state exchange, Google insurance exchange PA or visit The Pennsylvania Insurance Department has also set up a website to help Pennsylvanians navigate the process at Obviously, there will be additional problems and challenges that will need to be rectified during implementation. Regardless, the issue of health care in this country needs to be addressed. We will spend about $3 trillion on health care this year in the US; that’s 17.6% of our GDP, more than two-and-a-half times that of most developed countries. That’s about $8,233 per capita. Yet, the quality of the health care being provided in the US ranges between 32nd and 46th when compared globally, depending on the scale being used (32 [reported on NPR], 37 [WHO] and 46 [Bloomberg]).

Fortunately, the AOA has proactively positioned us into an alert posture. The AOA has unveiled AOAExcel to help ensure our information connectivity within the health care community. The AOA has also developed and the Accountable Care Organization (ACO) Resource Toolbox; additional resources that will help ensure our seat at the table. With these proper tools in hand, our profession can make a strong argument for optometry being an integral component of this health care reform. Optometry offers accessibility with over 36,000 optometrists serving over 6,500 communities (the only eye care provider in perhaps half of these) as compared to approximately 18,000 ophthalmologists. Optometry offers cost effectiveness; last year the inflation rate was 1.7% while health insurance costs had an increase of 9.9% and overall health care rose 3.2%. Eyewear and eye care increased 0.3%! Optometry offers quality care with the lowest malpractice rate as compared to all other health care providers.

The AOA has evidenced a strong presence and direction in Washington, D.C., by organizing over 600 optometrists and students to meet with their legislators in September and continuing legislative meetings into October with our AOA Board. Our national lobbying team, led by Jon Hymes, has been acknowledged as one of the best lobbying forces in DC, and has helped get our message across and ensure many of our recent victories. Yes, the best ensurance of our profession’s inclusion results from the diligence of our professional organizations (POA and AOA).

One of POA’s stellar successes over this past year is our gaining direct representation on the AOA Board with the election of Dr. Greg Caldwell. Dr. Caldwell has evidenced his tireless dedication to our profession at the state level and now extends his leadership on to the national level … “for the Love of Optometry.” It’s noteworthy that now the Northeast contingency has four AOA Trustees. In addition to Dr. Caldwell, we have Drs. Andrea Thau (NY), Chris Quinn (NJ) and Bob Layman (OH). That is more than one quarter of our 11-member AOA Board of Trustees.

At the state level, our executive director, in addition to his normal administrative duties, is serving on the Board of the PA eHealth Initiative (PAeHI), a public/private advocacy organization promoting electronic health records and health information exchanges – a critical seat in our informational networking. Our president-elect, Dr. Marianne Boltz, will be serving as our state’s ambassador and hostess for our national meeting POA and AOA at work for you: 2013 and beyond(Optometry’s Meeting) to be held in Philadelphia this upcoming spring. Dr. Boltz is ideally positioned in launching a campaign for pediatric eye care, which is one of the Essential Benefits granted under the ACA. While forging ahead for our eventful upcoming year, our Immediate Past President Dr. Donna Buraczewski has been overseeing internal housekeeping by coordinating our three-year strategic planning sessions and staffing transitions.

Your remaining Board trustees, Drs. Rich Christoph, Mark Margolies, Steve Eiss, Becca Wincek-Bateson and Lori Gray, have demonstrated a strong presence with their diligent engagement with third party payer negotiations and inclusion issues; diabetic initiatives, including the Pennsylvania Diabetic Eye Health Alliance (PDEHA); and legislative activities. Dr. Dave Evans is the incoming new member to our Board and offers additional clinical experience and legislative seasoning. Of course, this is just the frontline and administrative branch for our army of volunteers and our POA staff who serve as the unheralded force behind all the POA accomplishments.

I have shared some of the resources at hand that will help ensure our profession’s forward momentum. Certainly, you should make frequent stops to both the AOA and POA websites and read the AOA News, AOA First Look and the Keystoner, POA Today and the POAeyes Post to keep abreast of the rapid changes that are occurring. Better yet, if you are not directly involved at this point, become involved and volunteer for the advancement of your profession…we can all use additional hands with this workload.

Finally, on a personal note, I view this year as the pinnacle of my 30+ years of POA volunteerism. I am not a political animal, which I’m sure has been evidenced during this year’s tenure, but when you observe the hard work of the “20% who do 80% of the work,” there comes a time “to step up to the plate.” I sincerely admire the colleagues I have worked with; you can be proud of your team, they serve you well. I have appreciated their assistance, patience and support as we have forged ahead during this “roller coaster” year.

Robert L. Owens, O.D., F.A.A.O.
Pennsylvania Optometric Association

Thursday, September 12, 2013

The State of the Optometric Profession: 2013

An excellent program was presented by AOA Excel representatives at this year’s Optometry’s Meeting and I would like to share some of this valuable information with you.

Optometrists perform an estimated 88 million refractive eye exams annually (85% of the total 104 million performed by all eyecare professionals) and prescribe at least 90% of vision correction devices. Comprehensive eye exams and corrective devices account for at least 80% of the optometrist’s revenue. Of the 97 million office visits in 2012, approximately 18 million were for medical eyecare services, accounting for approximately 17% of revenue. It is estimated that 80-85% of optometrists are involved with medical eyecare, but it is a major source of income in less than 25% of these offices. The typical patient is examined once every 25 months. AOA member surveys show that the average number of comprehensive exams optometrists perform per hour is around 1.1 per hour.

Out of the 82.5 million pairs of glasses sold annually, corporate providers provided 54%, independent optometrists provided 32%, ophthalmologists provided 10%, and independent opticians provided 4%. Since independent optometrists perform 44% of refractive exams, they have a capture rate of approximately 73% or about 9.8 million pairs of glasses.

For contact lenses, optometrists provide about 90% of all contact lens prescriptions. It’s estimated that 16.1% of US adults wear contacts, a steady increase since the ‘70s, and account for 27% of the refractive exams performed by optometrists. Independent optometrists supply about 80% of their contact lens prescriptions.

Take home message: 1) Improve recall processes; 2) Upgrade eyewear purchase experience; 3) Broaden your scope of practice; 4) Increase hourly production; and 5) Differentiate the practice value proposition.

In 2012, there were about 40,000 optometrists in practice as compared to about 18,000 ophthalmologists. At the end of 2012, optometrists accounted for 69% of eyecare professionals in practice, by 2020 they will account for around 72%. The number of practicing optometrists has had steady growth of 1.8%. It is estimated that practicing optometrist growth will increase to approximately 2% annually through 2020 and reach 46,300. It’s also estimated that about 1,550 optometrists will graduate and enter practice annually while about 750 optometrists will retire. There will also be an expected gender shift. Over the next ten years, 65% of new optometrists will be females and 90% of retiring optometrists will be males. Currently, the male/female ratio is 61%/39%; in 2022, it is likely to be a 48%/52% ratio.

Approximately 57% of optometrists are in private practice, 24% have an optical chain affiliation; 8% are in an ophthalmology practice; and 5% are in other medical practices.

The number of practicing optometrists will grow faster than routine vision care demand (a projected 11% vs. 9% through 2020) but more slowly than the demand for medical eyecare (a projected increase in cataracts [2.3%], diabetic retinopathy, POAG, ARMD [1.8% each] through 2020). Presently, optometrists perform approximately 45% of Medicare-reimbursed comprehensive eye exams. The Census Bureau projects a 28% increase in individuals over 55 years of age between 2010 and 2020, while the total populations will grow by about 10%.

… Optometry’s largest opportunity is to increase eyecare demand among existing patients, expanding care to the elderly and other populations at risk for treatable diseases.

A historical review
Optometry’s scope of practice continues to broaden…
1897: First bill introduced to license optometrists in New York
1901: First law licensing optometrists enacted in Minnesota
1921: Last state law licensing optometrists enacted in Texas (D.C. enacted in 1924)
1923: Pennsylvania College of Optometry awarded first Doctor of Optometry degree
1971: First state law allowing the use of diagnostic drugs enacted in Rhode Island
1976: First state law allowing Rx of legend drugs enacted in W. Virginia (and on a veto override)
1976: First state authorizing Tx of glaucoma enacted in West Virginia 
1977: First state authorizing Rx of oral drugs enacted in North Carolina
1997: Last state authorizing Rx of legend drugs enacted in Massachusetts (D.C. in 1998)
1998: Authority to use therapeutic lasers enacted in Oklahoma
2011: Kentucky legislature becomes the first state to repeal a statutory prohibition on the performance of surgery by optometrists and the second state to authorize the use of therapeutic lasers
2013: Pediatric exams (and materials) decreed as an essential yearly health benefit, as the result of AOA legislative activity
2014: Under the ACA, increased insurance enrollment will expand accessibility to optometric eyecare

…As you can see, we are a legislated profession and we can thank organized optometry for progressing optometry forward. Be involved as a volunteer and as a donator to PAC funds to assure the continued evolution of your profession…as newly elected AOA trustee Dr. Greg Caldwell says, ”for the love of optometry.”

Robert L. Owens, O.D., F.A.A.O.
Pennsylvania Optometric Association

Friday, July 12, 2013

A time to splurge ... or a time to merge

When I joined an existing practice some thirty years ago, I was impressed with the technology my predecessor, Dr. A.E. “Buddy” Wascou, was using – he had 35mm fundal photography and an infrared autorefractor  (a Coherent Dioptron II)!  This latter instrument occupied a fair piece of real estate in his office and was introduced in the mid-seventies with a noteworthy price in the mid-twenties (1970s currency). Times have changed – we now have this technology of auto-refraction held in our hand, coupled with keratometry, to boot.

Through the eighties, the hot ticket items became biomicroscopy, Volk lenses, auto-perimetry and Polaroid fundal photography; soon followed by digital photography … just about the same time you had paid off your previous “goodies.”  As I recall, through the nineties most of our upper shelf clinical “toys” still remained in the mid-twenties price range (+/-).

Now, we have added a plethora of choices: OCTs (with or without anterior segment  assessment and auto-fluorescence), VEPs, the Optos Daytona, endothelial layer assessment, tear osmolarity, preferential hyperacuity perimetry, auto-phoropters, auto-screens, CSF testing, in office adeno-viral testing and AMD DNA testing. I’m sure I have just skimmed the surface and have not even mentioned that their integration into EHRs seems to need an air traffic controller at times.

To add to the neurosis, just about the time that I’ve befriended my OCT and humbled myself to its greater intelligence, I confront a new unit coming down from Canada which utilizes 12 LEDs (i.e., different wavelengths) to do an “en face” (layer by layer) portrayal of the retina through the RPE, auto-fluorescence, “fluorescent angiography” without the fluorescent dye … at about half the price of the present technology being unpacked. (This being the exception since now we are moving from the mid-twenties price range into the eighties to snag the top shelf stuff.)

Then, when I finally have time to stick my head outside my office to see what’s happening in the outside world, I no longer see any private medical practices in our county. I see surgical centers in which our MD colleagues have a vested interest. I see smaller practices merging into multi-specialty sites or at least larger groups.  I discover a new branch hospital that has displayed a disclosure sheet of all the doctors who have a vested interest in this new location.  Hmmm…

Reflecting back once again, in the late eighties, two of my classmates, Drs. Danny Kramer (NJ) and Scott Edmonds, had the foresight to initiate a movement of developing optometric referral centers – a site where a lot of our expensive “toys” could commune and become friends. (If my aging synapses still crackle, I believe the branded name was “CoCare.”)  Anyway, ODs would invest in these centers and subsequently refer patients for further evaluation instead of trying to squeeze additional instruments into their offices and create empty holes in their wallets.  

In our area, we had explored this possibility to the extent that one of our local hospitals had offered floor space for such a referral center; we had even started interviewing for an itinerant OMD as an employee to help staff our site, as required.  Once again, this was some twenty-five years ago … very progressive thinking for the time. Unfortunately, too progressive, and when dollars needed to be laid upon the table, it resembled a covey of quail.

Perhaps now with escalating third party plans, concurrent with the development of the home medical model, we should reevaluate our modus operandi. Perhaps we should pause, stick our heads outside of our private offices and observe how our medical colleagues are adjusting to this evolving environment.

I’m just saying….

Robert L. Owens, O.D., F.A.A.O.
Pennsylvania Optometric Association

Monday, May 13, 2013

WANTED: Full-time Optometrist

… for full-time engagement in his/her profession. After all, you don’t just call yourself an optometrist while you’re in the midst of examining a patient.

I want to offer you a warm, personal invitation to come to our Spring Congress. It will be held in my figurative backyard, Lancaster County, this weekend. The last time we held our annual Congress in Lancaster County was in 1999. That was the same year that our very own Harvey Hanlen was serving as our AOA President. Dr. Hanlen was the 6th Pennsylvania optometrist to serve as an AOA President since its beginning in 1898.

This year you can come help launch another Pennsylvanian onto the AOA Board  – Dr. Greg Caldwell. You’ve known him as an excellent lecturer; you’ve known him as a friend; and you’ve known him for his advocacy ... “for the love of optometry”! Come and support him as our next AOA trustee!

We will be holding our Congress right on the historic center square of Lancaster in the beautiful new Marriott Convention Center. A $177 million construction that sprouts from within the restored façade of the Watt & Shand Building; a blending of the Beaux Arts façade from 1898 and its later additions (1916 – 1925) with a luxury convention center of 220,000 sq. ft. and 299 rooms.

For those who recently enjoyed the movie Lincoln and the raucous behavior of Thaddeus Stevens, you’ll enjoy learning that the convention center’s construction also incorporated his house and law office into its structure. You can even look down into an archeological dig of his cistern believed to be a link with the underground railroad. Additional historical exposure can easily be obtained from a short drive over to Wheatland, the home of Pennsylvania’s only president – James Buchanan.

Actually, Lancaster and its surrounding area breathes history for it was once the gateway to the west. Frontiersmen would stock their wagons with staples before heading in wagon trains on to their western adventure. The Conestoga wagon took its name from the local Conestoga River. The term “stogie” (a cheap cigar) derived its name from the wagon drivers who smoked the low quality tobacco originally grown in this area. It was said that those following these wagons would comment that you could tell it was a “stogie” up ahead from the tobacco’s stench. The “Kentucky rifle” is actually misnamed since its origin was in Lancaster; the Pennsylvania Long Rifle was crafted by Germanic emigrants who moved into this area.

Center city offers an historic central market, a wide array of fine restaurants, art galleries and shops. Yes, my friends, you can even save your shoes and take Segway tours of downtown and its historic buildings.
Highlights of our meeting will include:

  • 11 hours of excellent continuing education, including: diagnosis/management of ocular pathology, OCT grand rounds, anterior segment grand rounds, HGPs – toric and specialty grand rounds and fitting scleral CLs. Also, Dan Tyree (northeast regional manager, VSP) will present a practice report. Please see the registration brochure on the POA website for details.
  • An excellent paraoptometric continuing education program, complementing the ODs’ program – so bring along your staff. Three nationally-known speakers will cover a wide variety of topics including time management, pre-testing, interacting with challenging patients, lens material/collaborative dispensing, anatomy, ocular effects of systemic disease … and even an eye dissection workshop – a loaded program that can enrich your office and staff.
  • The POA’s House of Delegates, where our professional business is conducted. If you’ve never attended, now is the time to start. As I stated in the last Keystoner – time to be a player. Unlike our federal deadlock, we are all on the same team – not red, blue, etc. We are all optometrists. Sometimes, we have differing perspectives, but this is our arena to hash things out and move forward. Attend, listen and offer input … be a player.
  • The Andy Mowatt Trio (POA Lobbyist Ted Mowatt’s son) will provide a talented musical ambiance for our exhibit hall/dinner. This is the last time Dr. Hanlen will be the coordinator of our exhibit hall, so come out and support our sponsors, vendors and Harvey.
  • Our annual golf tournament, held at the Conestoga Country Club on Friday at 7am. This scenic 6,400 yard, par 70 will provide both fun and challenge depending upon your intensity. Awards will be bestowed to both camps.
  • The Amish Storyteller will attend to educate and entertain our members about the Amish culture. No Amish Mafia here.
  • The Pennsylvania Paraoptometric Association’s 35th Anniversary, “Stamp to Success,” affording an opportunity to reward the paras’ involvement in our conference and win great prizes. Check this out! On Saturday night, my wife, Vicki, and I will help host the PPA’s celebratory reception with live music from Bryan Stevenson jamming with Shift Seven. This should be a lot of fun offering cover songs, original music, requests and even audience participation – rumor has it that our POA Trustee Mark Margolies is going to do an encore performance of his rockin’ Mustang Sally. Let your hair down, if you got it.

Kum … have a good time and get smarter.

Robert L. Owens, O.D., F.A.A.O.
Pennsylvania Optometric Association

Wednesday, April 17, 2013

Take a lesson from the fiscal cliff: Don’t give in to apathy, lethargy and loss of identity

As I was considering topics for my editorial, we sat on the edge of the “fiscal cliff,” attempting to avert the looming sequestration process. We escaped some of the cliff but not sequestration. The idea of the sequestration was to force Congress into being more actively engaged to creatively tackle the national debt; avoid the automatic $1.2 trillion cuts over a ten-year period, a 50/50 split in spending cuts between defense and domestic discretionary spending.

As I write this, Congress sits with approval ratings in the teens, teetering on hitting the all-time record low of 10% set this time last year and matched in August 2012. By the time you read this, perhaps we will have set a new record low. The RCP poll averaged the results of seven different polls and found the mean approval/disapproval value of 15.6%/78.8%; the range was 14-18% approval versus 74-82% disapproval. And yet, what have “we” done? Over 75% of those polled expressed disapproval on how Congress was running their shop but, once again, what have we done?

I’m by no means a political analyst nor even a political animal by nature, but it strikes me that there’s a bad brew of apathy, lethargy and a loss of identity. How well do you think your practice would fare if 78% of your patients disapproved of the job you did? Would you be motivated to readjust, rethink and retool so your future employment was more secure? Why don’t our politicians feel the same “heat” that we would if we faced those numbers? Perhaps we haven’t become involved – personally exerted enough energy to heat things up. Perhaps we naively delude ourselves that if we simply express our displeasure, things should change for our greater satisfaction.

This is where the apathy rolls over into lethargy ... “I’m really not happy with what’s occurring and I really would appreciate it if it were changed but ...” I’m not motivated enough to do anything about it; I’ll just grumble, grab my ball and head home; I won’t be engaged; I won’t be a player. Boy, am I glad our founding fathers had more spunk than that! Historically, we have certainly had heated debates and political battles, but things have always progressed forward. The art of the compromise, in order to accomplish a higher mutual goal – what best serves Americans.

This is where lethargy rolls over into a loss of identity. Have you ever noticed in sports when one of your local rival teams reaches a higher level, you’ll root for them rather than a team from a neighboring state? A similar pattern follows if the neighboring state competes with a state on the other side of the country or a foreign team. It’s an identity thing. Politics should not be like sports teams, though. When you trim it to the sinew, it doesn’t matter if you’re on the red team or the blue team since you’re both on the same team – the red, white and blue team. Sounds hooky but it’s true.

Not long ago, to curtail costs our local newspaper in Lancaster combined its morning paper with its evening paper. Since one edition was more conservative than the other, it added two editorial pages rather than just one. In that way, it could appease both the more conservative and more liberal reader. Now, I really wonder how much cross-reading occurs. There exists “truth” on both sides. The art is to glean the best and blend. As Aristotle put it: “The greatest good for the greatest number.”

Okay, okay so what does this have to do with optometry? We must be personally involved and active. We must be a player both at the local level and state level. We must communicate with our legislators. We must be engaged politically in our professional arena by attending our “Congress” – the House of Delegates – at our annual conference in May. We must cooperatively listen, discuss and hone in on common goals that move optometry forward. We ARE ALL optometrists and we ARE ALL practicing a legislated profession. This means that ALL our professional privileges and scope of practice is reliant upon legislation ... it is not a “given.”

Robert L. Owens, O.D., F.A.A.O.
Pennsylvania Optometric Association