Fall 2017
ICO Matters Cover Fall 2017

Disrupting the Disruptors
dis-rupt (verb): to interrupt, by causing a disturbance or problem; to drastically alter the structure of something; upset, obstruct, impede, interfere with, distort. Strong words, but most optometrists can relate. The word “disruptive” is accurate when describing the growth of online optometric services.
Written by Sheila Quirke

Disruptors rely heavily on ophthalmologists. Ophthalmologists have the legal capacity to write prescriptions across state lines that optometrists do not, leaving optometrists vulnerable. That regulation is a tough nut to crack. In response, the AOA supports telehealth, “a rapidly-evolving tool for the delivery of health information and services.” They believe that “eye and vision telehealth services, when used appropriately, can serve to improve patient coordination and communication among and between doctors of optometry and ophthalmologists, as well as other primary care or specialty care providers.”

In addition to following AOA recommendations, ICO alumni are using a three-pronged approach to disrupt the disruptors. They engage in advocacy to lobby for favorable legislation, exercise education and top shelf customer service to attract and retain patients, and provide the latest technologies.

Abby Jakob, OD ’14, is the owner/operator of EYES, a practice in Ontario, Canada. Dr. Jakob provides personalized care to patients ranging in age from infants to centenarians. She is passionate about pairing state-of-the-art technology with an awareness of specialized needs. “Technology helps me provide the most thorough exam possible, and by pairing that with patient education, my patients understand they are getting a compassionate and caring doctor.”

For Dr. Jakob, that means providing a welcoming and friendly environment, having equipment that is wheelchair accessible, and making certain her patients “feel like gold.” She has had tremendous success targeting those patients most readily served by online disruptors – Millennials. She uses social media to highlight her fresh product line and well-appointed office via Instagram and Facebook, which attracts younger patients.

Is Dr. Jakob concerned about the growth of online refraction? No. “There is no way to integrate a patient’s lifestyle or habits into an online exam. The prescription provided may be crystal clear, but still not right. There is no substitute for a professional asking the right questions and reading the patient as they are examined.” Dr. Jakob acknowledges it may be easier for her to adapt as a new OD who appreciates that older patients require a more traditional approach while her younger patients are comfortable with modern technology and different means to communicate with her. “People need options.”

The reality of patients exploring options like online vendors is the elephant in the room Melissa Spaulding, OD ’15, is never afraid to address with her patients. As a provider at Front Range Eye Health Center in Colorado, Dr. Spaulding never shames a patient who requests a written prescription. “We are doctors of optometry, not salesmen. My number one goal is education. I check for diabetes and glaucoma, and ask about dry eyes and allergies- things many patients never think to bring up, but have a lot of questions about. I want to capture 100% of my patients with a more thorough eye exam.”

Dr. Stephanie Messner agrees with this strategy. She hopes ICO students and alumni will “fully participate in medical optometry and vision rehabilitation so that their practices aren’t solely dependent on refractive eye care.” A practice with multiple services and specialties will adapt and survive when the marketplace changes.


“All of this is overseen by a “normal employee,” which one can assume is not a doctor of optometry.”

Ryan Ames, OD ’07, is a strong advocate for, well, advocacy. Through his work at ForeSight, LLC based in Wisconsin, Dr. Ames has seen the benefits of state and national associations. “Optometrists must get involved. Donations to both the state associations and the American Optometric Association PAC are crucial. If every OD gave just $50 a month, we would have enough funds to fight. Industry forces are coming armed with millions of dollars. We need the same arsenal.”

Dr. Ames believes focusing on education and technology enables patients to ultimately become better advocates for themselves. “We must focus on telling patients why they need to see us routinely. As we examine the eye, we need to tell them what we are looking at and why. Then, if the patient does consider an online refraction, they will at least be educated on what is missing when they do it.”

Patients take notice of changing technologies, too. Dr. Ames notes, “When we are spinning wheels on the same black instrument from the 1950s, they will start to wonder why we are still using it when other technology is available. Marketing is a matter of perception, not reality. Even if both instruments produce similar results, they look very different. All the patient knows is that when they went to the optometrist, they got a new prescription. And when they did the exam in their kitchen, they got a new prescription.”

Optometrists must cast a brighter light on what the profession uniquely provides. The AOA “will continue to hold companies accountable for any claims they make that potentially put patient health at risk.” While they do, know your value and don’t be shy about sharing it. Use the tools available to you: advocacy, technology, and the expertise to provide patients with the best care available to them. No app in the world can replace that.

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