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John Marvin

The Optometry Profession Is Changing, Let’s Calculate the Price of That Change

Because as President Bill Clinton once said, “The price of doing the same old thing is far higher than the price of change.”




OUR INDUSTRY AND the optometry profession are changing. This is a fact.

Whether or not these changes are good for the profession is a debate that we should have but no one seems to be willing to address the elephant in the room.

The hiring of associate doctors has become a universal difficulty. The irony is that this difficulty is not due to a shortage of optometrists, but optometrists who want to work full-time. In many cases, two or three optometrists must be hired to equal one full-time equivalent in terms of OD hours.

This is complicated for the private practice owner who wants and needs help because corporate optometry, with far more resources than private practice, is willing to pay salaries and day fees far beyond what makes economic sense. The old metrics of OD compensation to revenue ratios have been thrown out the window.

Recently, I attended a conference featuring innovation in the eyecare space. A curated list of new companies presented equipment and software powered by artificial intelligence. Interestingly and frankly surprising, most of these companies are directing the sales efforts for these innovations at the medical healthcare community, not optometry. Speakers explained that by adopting this new technology, primary care medical doctors and not optometry can now screen for cardiovascular, neurological, and metabolic disorders using high-resolution retinal images read by artificial intelligence software. The patient can then be referred to the proper medical specialists for care when needed. The practice of eyecare is changing.

Today, online optical sales have almost doubled since before the world went crazy with COVID lockdowns and trillions of government cash pumped into the system. Practically every category of retail can now be ordered online. The fact is, the optometry profession is a retail business. More than two-thirds of the revenue generated by optometrists in the US comes from the optical dispensary.


People who would have never thought about ordering prescription eyewear online are doing so in staggering numbers, and many report being extremely satisfied with their purchase.

Cost and price are other important areas of change. Today, there is a growing imbalance between the cost paid by private practitioners and the price consumers are willing to pay. Companies aggressively advertise multiple pairs of eyewear and no-cost eye exams for less than $100 to consumers who are patients of private practice. Recently, I had a comprehensive eye exam, purchased one pair of prescription glasses, and a one-year supply of daily disposable contact lenses. The total cost of this service and eyewear purchases was over $2,600. Imagine if I was not in this profession and paid this amount, and then I saw a television advertisement promoting two pairs of glasses and an eye exam for $99. Wouldn’t I be expected to ask why I paid over $2,600? Of course I would.

So what are we to do? Can we do anything? I believe this has to change for the sake of private practice. Because as President Bill Clinton once said, “The price of doing the same old thing is far higher than the price of change.”

John D. Marvin has more than 25 years of experience in the ophthalmic and optometric practice industry. He is the president of Texas State Optical and writes about marketing, management and education at the blog. You can email him at


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