Measuring trends in optometric practice: a study in Oregon.

BACKGROUND: Considerable change has occurred in the United States, over the past several years, broadening the scope of optometry to include the treatment of ocular disease. This change has received a great deal of "press", however little has been done to measure actual trends occurring in the practice of optometry. A study was undertaken in 1991 to establish an accurate profile of optometric practice in the state of Oregon including trends over the past five years and those projected into the next five years. METHODS: A sampling of all optometrist (465) in the state was done early in 1991, query being made as to five years back (1986) and five years ahead (1996) relative to various practice characteristics. The return rate was 51%. RESULTS: It was found that general examinations, spectacles, and contact lenses are services offered by, essentially, every office. However, there is considerable variation, office-to-office, on all other services. Projections into the next five years forecast increased services in contact lenses, vision therapy, and the management/treatment of ocular disease. As to technology, trends indicate greater use of auto-refractors, auto-keratometers, automated visual fields, and binocular indirect opthalmoscopy. CONCLUSIONS: Optometrists in Oregon are optimistic on the projected growth of particular services. While this outlook seems to be based on an existing patient base in most areas of care, it appears to assume that projected treatment privileges will attract a new and expanded base of patients relative to ocular disease.

The delivery of health care and eye care in Japan.

Japan has developed a socialized system of health care delivery operated under a governmental social insurance plan. It is all inclusive in that no matter what the working status, each individual is covered. Outcomes of the system are impressive, reporting the highest life expectancy and the lowest infant mortality rates in the world. Optometry as a legalized profession is not presently recognized in Japan, even though it is common practice for the public to visit optical shops to receive routine eye examinations and lens prescriptions. There is a movement in Japan to provide optometric education and qualifying examinations comparable to international standards.

Access, provision, and cost of routine eye care: a comparison of Oregon optometrists and ophthalmologists.

BACKGROUND: Over one-third of Americans have a disease or functional abnormality in one or both eyes. Only about half of those needing treatment are receiving it. Access to eye and vision care has been a major concern within the public health community yet few definitive studies exist to determine availability of such care and by whom. To address this issue, a study was conducted among optometrists and ophthalmologists who practice in Oregon. METHOD: All optometric and ophthalmologic offices in 1991 were surveyed utilizing a 'blind' telephone interview technique. Information was gathered on the provision of routine eye exams, fees, and visual field testing as well as appointment availability and acceptance of Medicare and Medicaid. RESULTS: Significant differences were found in routine exam fees and availability, provision and fees for visual field testing, and Medicare and/or Medicaid acceptance between the two provider groups. CONCLUSION: Access to optometric care is greater as measured by number of providers, appointment availability and cost. Therefore, optometrists are more accessible and cost effective than other vision care providers.

Office image as a determinant in the choice of an optometrist.

While many offer advice on the marketing of optometric services, little research is actually reported. Many factors may influence the public's decision to choose one practice over another. Two research projects were conducted, both dealing with the question of image and public preference. One used external office appearance as the variable; the other used printed material as the variable. Six different clinical scenarios were used to determine what influence various visual "problems" might have upon the patient's choice of a practice. Results indicate that the image of a practice--represented by both the external appearance and through printed material--plays an important role in the preference of one over another. Choice is also influenced by the nature of the services being sought. When seeking services for clinical situations, the public shows a strong preference for practices imaged around comprehensive professional services. When seeking services for an optical appliance, patients are just as likely to choose a practice that promotes eyewear.