It had to happen somewhere and Utah makes sense.
For over two decades, I’ve predicted that one day, an eye exam would be dispensed like so much gum…from a vending machine. Technology is sometimes cruel and forces are at work to bring such a possibility to reality.
Consider:
a) Auto-Refracting Technology is pretty darn accurate.
b) The regulatory line has been crossed. Since 2010, in British Columbia, a consumer no longer needs a doctor’s Rx to obtain eyewear or contacts.
c) In that same province, last year, optometrists were prevented from charging for a PD measurement. It’s part of the eye exam.
d) It’s no secret that now, some 3% of eyewear is delivered through internet channels. People are getting used to self-serve technology.
e) apps exist to do exams and measure for lenses.
f) SoloHealth, a firm that has developed and is installing screening kiosks in store, now has locations in over 1,200 retail locations around the U.S., including Sam’s Club and Walmart stores. The company plans to expand to more than 2,500 store locations by mid-2013 and 4,000 by 2014. An advertising partner is J&J. An investor is WellPoint. WellPoint controls over 35 million lives. They acquired 1-800 Contacts last year. Their published objective is “To Create the Best Health Care Value in Our Industry.” Get the connection? Coincidence?
So, it comes as no surprise to read this letter: Defense (1)
My advice to optometry…wake up and smell the coffee. Get out of vision plans to reduce your risk of concentration (too many customers from one source). Who do you think will be the first folks to send their patients to a kiosk for an exam? Who do you think wants to sell contacts without an Rx? Those with the most to gain…vision plans.
And you’d better be supporting your associations and PACs. They’re the only ones that can fight this fight on your behalf.
I can understand the threats posed by such ominous developments in the optical field, but pointing the finger at ‘vision plans’ makes no sense to me. Certainly certain plans such as Eyemed, Davis, Spectera which are owned by retailers are a threat, and J&J contacts is a terrible disappointment to private practice optometry. But to make a blanket statement that ‘vision plans’ are the evil empire to cause optometry’s demise altogether is simplistic and misleading. Even though VSP does not do 100% of what we OD’s may prefer, they are attempting to stay informed of market trends, stay ahead of the curve, and put tools into private practice optometrists hands to remain competitive in this rapidly changing landscape. Besides our collective state associations and state PACs working for us, I continue to see an ally in VSP. I do agree that we are stronger together and need to support our state associations and PACs. But let’s not throw the one and only vision plan created and governed by private practice OD’s under the bus when they are one of the primary reasons we OD’s have been able to come to and stay in this competitive arena. One only has to look at what’s going on around the world (Canada, Australia, Great Britain) with Spec Savers and the commercialization of optometry to know that we need all the true allies we can muster.
NOTE: DR. KUHLMANN IS THE VSP REPRESENTATIVE FOR OHIO
I appreciate the commentary that appears as if it were written by a PR department and I only wished that you had disclosed your association with VSP.
I am curious. Can you inform me as to how VSP is governed by private practice ODs? Yes, VSP was created by optometrists, but the profession long ago turned over leadership and control to the staff and VSP long ago abandoned the profession for anything other than pure business (and there’s nothing wrong with business…just be honest). Do the VSP providers elect the Board of Directors? Does the Board work independent of the officers of the firm? What controls are in place to ensure that the Board of Directors is governing the firm to the sole benefit of it’s so called “stakeholders” (described by you as private practice optometry)? Does VSP publish its financial statements to its stakeholders, like every other similar enterprise?
And having just returned from Australia and New Zealand, I know first hand what is going on with SpecSavers in that country. VSP is NOT the answer.
Al, Please pay them a visit at Vision Expo. Bring your questions and a camera phone. We’d all love to see the answers.
Yes, I have signed my post because I have nothing to hide. I am one of 2 VSP SPR’s (State Professional Representatives) for Ohio. Many ODs may not know what that means, so I will elaborate. I am a private practice OD who opened my own practice cold 25 years ago, and I still work in it full time along with 2 other OD’s. Five years ago, I was asked by VSP to fill a vacant SPR position for Ohio. SPR’s act as liaisons between ODs and VSP. In other words, I help VSP to understand what ODs are thinking and needing, and vice versa. I am NOT on the VSP payroll; my motivation of accepting this position is to try to be a positive force for optometry. VSP is the only third party insurer to have this kind of link to doctors; they truly do care about what ODs think, even if as an insurance business, they cannot always please ODs with all their programs. As you point out, VSP is a business, and must make decisions for a variety of reasons we as ODs don’t always agree with or understand. These reasons include staying viable as a business in today’s marketplace, staying true to state and federal laws, and operating as a not-for-profit entity. Even though in the eyes of the IRS VSP no longer has the not-for-profit status (VSP pays tax to the IRS), VSP still operates as if it were a not-for-profit entity, paying out 90% of the collected revenue to doctors and labs, keeping only 10% for administrative costs. VSP is not a publicly held company, so have no stockholders to whom they pay dividends, unlike other third party plans. The Board of directors is appointed, a similar practice in most businesses, and is made up of 10 private practice ODs, one MD, and 2 CPA’s. All 5 Board officers are ODs. The staff and Board work together to advise each other on decisions, so that the business and OD voices are heard; again, probably the only third party plan with any substantial OD input. Can you tell me that any of the other third party plans have any care about what ODs think or need? Do any of them have a Board of Directors made up mostly of ODs? What will happen to our voice if the Medical Third Party plans are calling all the shots for future eye care under the new healthcare exchanges pursuant to the implementation of the ACA? It would be helpful if the AOA and VSP lobbyists were working together on this, again, I stress the need for allies in optometry.
You may have missed my main point, which was not to say that VSP is the answer, but can be our ally. To reiterate, “Besides our collective state associations and state PACs working for us, I continue to see an ally in VSP. I do agree that we are stronger together and need to support our state associations and PACs.” I think we need to keep all the cards we can in our hand.
Mr Cleinman, I appreciate your passion for optometry.
Incidentally, I have personally written this comment, not a VSP PR department.
Dr. Kuhlmann,
I appreciate and respect your position. That said, I continue to believe that VSP does not operate in the best interests of its providers. That fact should be clear to you in Ohio, where VSP has moved to sell eyewear and its plans directly to consumers. VSP clearly communicates its strategy, not in its massive PR efforts, but in its actions. Are they better than other vision plans? No, in my opinion. All such plans act for their own purpose. But only VSP hides behind its historical non-profit status and its roots as being owned by optometry. VSP is a commercial enterprise no different than any other with but one objective, to make money for it’s stakeholder (staff).
As for governance, I take no solace that VSP’s board is dominated by optometrists. These individuals are highly compensated directly and indirectly for their services. They are appointed, I believe, not by outside directors or an independent nominating committee. VSP’s structure is not transparent, as that of any other “non-profit.” They operate in a haze of obfuscation with no oversight by the very providers for whom they purportedly serve.
The American consumer doesn’t need a vision plan to acquire eyewear or even an eye exam at a price point which they find appealing. The marketplace has accomplished that with the likes of Walmart, Costco and scores of other discounters. I see no benefit in insuring a scheduled benefit any more than I would insure an oil change for my car. What I do see is the promulgation of our industry’s brand as being overpriced…thus the heavy discounts and BOGOs. As the saying goes, “in the absence of anything else, price prevails.”
Thank you for your contribution to the dialogue.
Al Cleinman
I appreciate and respect your position. That said, I continue to believe that VSP does not operate in the best interests of its providers. That fact should be clear to you in Ohio, where VSP has moved to sell eyewear and its plans directly to consumers.
Historically speaking Al, VSP has been about providing high-quality, cost-effective eyecare benefits to consumers thus they are right in line with their mission from day one. They do so with the best interests of private practice in mind not retail. OD’s are service providers for VSP’s clients employees, plain and simple. Don’t like it, then go get clients on your own and don’t join any managed care panels.
VSP is a business and yes, they have their own purpose too. Show me another company that invests it’s profits and dollars and energy into private practice nearly as much without answering to a board of investors screaming about meeting wall street numbers for it’s “investors” I love how you try and slam them for trying to support their staff. Do you do the same for the private practice OD’s helping support their staff?
You seem to have little understanding of their board too. Their top dog is in private practice and runs a business just like any OD. Want transparency, just ask them. I’ve never had a problem getting an answer from any of their leadership.
“The American consumer doesn?t need a vision plan to acquire eyewear or even an eye exam at a price point which they find appealing. The marketplace has accomplished that with the likes of Walmart, Costco and scores of other discounters.”
^^ So what you’re saying above is that having patients walk into Walmart or Coscto or other discounters would benefit the private OD? Interesting. So by your thinking the average managed care card holder would rather go to a discounter vs getting a discount from a private practice OD? Really? I also never knew a service provider OD was forced to be on a managed care panel.
“I see no benefit in insuring a scheduled benefit any more than I would insure an oil change for my car. What I do see is the promulgation of our industry?s brand as being overpriced?thus the heavy discounts and BOGOs. As the saying goes, ?in the absence of anything else, price prevails.?
^^ so managed care is the cause of BOGO’s and over priced products and services? I’ll remember that the next time I see a private practice OD advertising such programs. Ironically, it most often retail who is leveraging popular brands and cheap offers to compete and steal consumers who would rather use a managed care plan to fund their private practice services.