AOA tells White House and VSP: Our Profession must be Defined by Optometry

November 22, 2011

November 21, 2011

Dear Colleague:

Friday I was once again at the White House to continue our push to make comprehensive eye exams the basis of the new health care law’s essential pediatric vision benefit. As I left, I received an e-mail from VSP that served as a fresh reminder that optometry’s future is not only threatened by organized medicine but also by other outside forces that want to define and control us.

I am surprised at both the tone and the not-so-subtle threats it contained to practicing optometrists, the AOA and the “leadership” of the AOA, i.e., me. Perhaps they wanted to distract doctors from the many other issues of concern between them and VSP, but the personal attack was a bit of a surprise. A large portion of the comments made by Dr. Mannen were not correct.

Let me be very clear. More than anything else, as AOA president, I’m committed to ensuring that neither medicine nor insurers gain the ability to define optometry. Medicine continues to attempt to define optometry by what we are not. Insurance companies attempt to define us by the services for which they reimburse us. The former is overt, the latter more covert. It is clearly critical that optometrists define optometry.

Being in DC whenever needed to lobby for optometry comes with this job. From my trips here I can tell you the battle over health care that began in 2009 rages on, and the stakes remain high. The AOA, and only the AOA, fought for a seat at the table and made expanded patient access to optometric care our priority, and we got results:

  • We backed the Harkin anti-discrimination amendment, and now we alone are standing up to the AMA’s efforts to repeal it.
  • We backed the designation of pediatric vision care as essential, and now we alone are fighting to put a comprehensive eye exam at the center of it.
  • We backed an end to artificial restrictions on our services imposed by health plans, including stand-alone plans whose business model isolates optometry from the rest of health care as if somehow vision care “stands alone” from primary health care. Because of the AOA’s efforts we now stand ready to care for millions of new patients who will gain coverage.

All of these critically important issues have been fought by the AOA and the AOA alone. There were no insurance companies “advocating” for the profession. And that’s to be expected because they have their business models to protect. We have optometrists and our patients to protect.

With regard to stand-alone vision plans, they absolutely can participate in the state health insurance exchanges now being created. They can do so by working with qualified health plans to assure the delivery of the full range of essential eye care services we provide our patients.

But they want something more. They want a special loophole in the law that would allow them to continue to profit at the levels they have in the past while maintaining a barrier to segregate optometry from the mainstream of health care. That status quo is good for some insurance companies, but it’s not good for optometrists or our patients. “Standing alone” is in their best interests, but in the new world order it is clear it will no longer be good for optometry.

Although I’m surprised to be attacked personally, my primary concern is the needless damage being done to our profession and to our advocacy efforts, which I can tell you from my visits this week on Capitol Hill and the White House is distracting and taking away from our efforts to define the pediatric benefit as an eye exam.

The AOA has no interest in fighting a battle in the media or anywhere else for that matter with VSP. The AOA has no interest in harming VSP. I actually don’t know how the AOA could harm a $3 billion insurance company. And while the AOA cannot ever hope to match the PR campaigns of this industry giant, we do believe that common ground can be found on a number of issues facing our patients, our doctors and our nation.

I have reached out to VSP many times to discuss areas we think might be of mutual interest, such as the definition of the pediatric benefit. I will again. So far, VSP has not agreed to assist optometry in that battle, and we are going it alone. By the way, our last scheduled meeting in which the AOA had many items on the agenda to benefit optometry was canceled by VSP on June 9. I thought then, and I still think now, it was a missed opportunity. On Sept. 30, I again sent Dr. Jankowski, VSP board chair, an e-mail telling him the AOA’s door was still open for dialogue on areas of common interest with no positive response. Perhaps Dr. Mannen was not aware of those important facts.

I have every confidence we are on the right track. We will not let medicine or insurance companies define us and limit our practices for their benefit. Our members can be assured that the integration and independence of optometrists is and always will be at the forefront of my mind and the efforts of the AOA.

Dori Carlson, O.D.
President, American Optometric Association


  1. What did the email from VSP say?

  2. Please post the email from VSP.

  3. What did the VSP email say? What were the “threats to optometry”? What comments were made that were not correct?

  4. Please post the email from VSP.

  5. I want to see the VSP email.

  6. There is the opportunity to discuss each organization’s position on the Health Care Reform discussion at http://connect.aoa.org (AOA members only)

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