Carlson issues State of the Profession address

February 8, 2012

AOA President Dori Carlson, O.D., issues the State of the Profession address, available to view here .

The following is the text of her address.


I’m Dr. Dori Carlson, president of the American Optometric Association.  This is the time of year we hear “State of the Union” or “State of the State” addresses.  So in that vein, I’d like to give you all a brief “State of the Profession” Address. In other words, “How are we doing as an association and as a profession?”

I am proud to answer that “the State of the AOA, and the State of the Profession, thanks to the AOA, is sound.”

In 2011, and already in 2012, the AOA has continued to score victories for optometry in Washington and has continued to assist affiliates in their state legislative and regulatory battles.

We have continued to build on our earlier victories on Capitol Hill.

You may recall that as the Affordable Care Act began its long and convoluted trip through Congress, the AOA stayed focused, not on the pros and cons of the bill itself but on the opportunity health care reform provided our patients to improve access to optometrists.  And so, we advocated strongly for a children’s’ eye and vision benefit to be a part of the essential benefit for insurance plans in the exchange.  AND WE WON!

Following that win, organized medicine declared war on the children’s benefit and tried to reduce it to a simple vision screening at the pediatrician’s office instead of a comprehensive eye examination by an eye doctor.  They pulled out all the stops.  But so did the AOA.  The AOA lobbied hard to ensure that kids could truly get the care they needed.  And in December, a CMS ruling referenced benefit plans that included comprehensive eye exams as the model for the exchanges.  Screenings weren’t even mentioned.  Now, as in much of the ACA, the battle moves to the states for implementation of those recommendations.  And the AOA will continue to support the efforts of our affiliates on this important issue.

This week, I’m hearing that many of our members are now receiving generous payments from CMS for implementing EHR in their practices thanks to our earlier victory in changing language in the American Recovery and Reinvestment Act of 2009.  The original language specifically excluded optometrists from being eligible to receive this important payment– that is until the AOA stepped in.  That one payment will cover the average members’ dues for 22.5 years!  How’s that for a return on your investment?

AOA continues to fight for our reimbursements with Medicare.  In fact, in spite of all of the ups and downs at Medicare and the political wrangling, the codes used most by optometrists have actually seen a slight INCREASE in reimbursement while the vast majority of other providers have had to deal with substantial decreases in reimbursement.  This year, optometrists will receive over a BILLION dollars in Medicare reimbursements.  That works out to several thousand dollars per member; another very tangible return on our investment into AOA.

Together states and the AOA have defended optometry payments and procedures covered in over a dozen states regarding Tricare, as well as other third party payers.  Our Third Party Care Committee continues to press forward to make the case for optometry’s role in value-based health care, and patient access to optometry.  Today, the United Auto Workers now integrate optometrists into the medical plans for eye and vision care in parity with medicine.  Additionally, historic scope of practice battles are being won all over the country.

Our PAC raised over $2 million in the last election cycle.  That is a record, and we are now one of the largest health care PACs in the country.

Our optometry public affairs campaign is now in its 7th year and thanks to the AOA, and your support of the AOA, we are now positioned as the “go to” organization when the media needs information about eyes, eye care and vision.  The public is now getting to know us as a critically important component to their health care.  Just this month I was quoted in Family Circle Magazine.

Financially, we continue to be strong because of your commitment to the AOA, and the AOA Board’s resolve to control costs and redirect resources to advocacy efforts both federally and statewide.

Our budget has seen modest growth over the last few years. And the demands on those resources are shifting all the time.  Your AOA Board is committed to a nimble financial strategy to allocate resources where and when they need to be allocated.   We also are committed to rebuilding our reserves which have taken a hit after the 2008 market crash and the simultaneous funding of the defined benefit retirement plan.  Nevertheless, the budget we are presenting to the House of Delegates in June will seek a $1 million addition to our reserves.

This demands both fiscal responsibility and fiscal agility, and it can and will be done.

Our membership and market share remains much higher than most health care associations.

The good news about membership is that we have roughly the same number of members today as we had in 2008.  The bad news about membership is that we have roughly the same number of members today as we had in 2008.  As we have drilled down on the membership issue, it is clear that our new graduates are not converting their membership from student status to active status at the rates that we have historically enjoyed.  Our members on the “back 9” of their careers are beginning to retire and semi- retire faster than the new grads are joining.  This must be and will be addressed, and I have already begun that effort by visiting every school and college of optometry personally over the past 20 months and taking our message directly to students across the country.

We have enjoyed great success in these last few years.  Yet much remains to be accomplished.  We will have to again do our best to predict the future and proactively engage that future while defending the gains already achieved.

1)      Medicine has already declared war on the Harkin amendment, which would clearly diminish patient’s access to their optometrist.

2)    States are seeing record numbers of anti-patient and anti-access bills introduced into their legislatures.

3)    A change in the administration or control of either or both Houses of Congress will reshuffle the deck on health care reform.  We must be prepared for that.

Attacks from outside our profession have been vigorous.  But so have attacks from within the profession.  The “Factually Bankrupt” foes of the AOA have turned up the volume of their deliberate misrepresentations designed to confuse and destroy.  If you have a question about your AOA, don’t hesitate to contact me or another board member.  Our books have always been open to you.  Annually, we publish audited financial statements to insure transparency and integrity.    You deserve an open, honest and responsible AOA.  Intentionally misleading attacks that serve to give aid and comfort to optometry’s enemies simply can no longer be ignored.  We defend our association and its mission; not for the sake of the association, but for the sake of optometry, our members, and most importantly the patients we serve.

The AOA is committed to moving optometry forward in this new age of health care.  Some have attacked us for bold moves at a time when bold moves are essential to our profession’s survival.  The world is moving very fast – sometimes faster than you and I would want.  But the status quo just won’t cut it in the months and years ahead.

The changes ahead are sometimes daunting.  And as with all change in life, it comes with both risk and great opportunity.  The AOA is the only organization with the will, the means, and the manpower to minimize that risk and capitalize on the opportunity for our members and the patients we serve.  We put the “boots on the ground” for our profession every day.

As a member of this great organization, you have already joined me in that effort.  Thank you.  I ask you to continue to be an advocate for our profession and our patients.  If you know optometrists who are not members, invite them back into the family to join us.  I, and the AOA Board, cannot do this job alone.  We need each and every optometrist, private practice, employed, academic, or federal.  We need all of you.

Thank you for what each and every one of you do every day to enhance our profession and move us forward.  When we move together, we move mountains.  We always have, and we always will.

Thank you!

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