Background
In 1952 D rose to a brief record high of 14 from graduates under the “GI Bill” but steadily declined to 10 by 1967 when there were 12 U.S. schools of optometry and graduation rates of around 500. [Figures 2, 2a] There are 20 US schools of optometry with 2 more expected and the most recent graduating classes totaled 1,567.
During the 30 years after 1969, additional schools opened, enrollments rose, and D slowly increased. When the 1997 national Census of Optometrists was conducted, in cooperation with the American Optometric Association (AOA), D had risen to 11.5 and graduation rates were hovering around 1,127. [Footnote 4]
In 2000, Abt. Associates released its “Workforce Study of Optometrists”, based upon the 1997 Optometry Census. This report projected future surpluses (just over 4,000 by 2015) and higher D’s, if no additional schools opened and graduation rates remained at 1,127 per year.
Following this 2000 study, additional schools of optometry opened, entering classes rose by 2012 to 1,760, and two more schools plan to enroll graduates by 2018 creating total future graduation rates of perhaps nearly 1,900 per year. [Footnote 5]
During this recent expansion the numbers of qualified applicants per seat declined to the level that in 2012 some seats went unfilled due to a lack of qualified “back-up” applicants.
Based upon this study, graduation rates by 2018 may be as much as 73% above the levels of 1997, when D = 11.5 and supply equaled demand.
This growth in graduates far outstrips the growth of US population since 1997 with the latter increasing at a rate of only 0.87% per year and projected to decline further by the Census Bureau. [Figure 1]
1967 Graduation rate = 500, Population = 199 million D =10
1997 Graduation rate = 1,127, Population = 266 million D =11.5 [Supply = Demand]
2014 Graduation rate = 1,600, Population = 317 million D =13.4
2018 Graduation rate = 1,900, Population = 340 million D =14.0
The population growth rate continues to decline. The average rate for the last century was 1.3% per year but fell below 1% 15 years ago and is now at 0.87% due to a drop in fertility rates. Without immigrations the rate would be even lower and the Census Bureau predicts further lowering of the growth rate over the next 40 years.
The 2000 Abt. manpower study was funded by the AOA which fully cooperated in the study. [Abt. stated “we are indebted to members of the AOA Workforce Committee, who have provided us with data, advice, criticism, and support throughout the project.”]. One member of the AOA Workforce Committee later served as the AOA Executive Director.
Since the Abt. report believed “supply was equal to demand” on the basis of the 1997 Project Hope Census data, when D was 11.5, this value for D will serve as a benchmark against which future densities are compared.
The Abt. projection for numbers of optometrists in 2012 agrees very closely with the value of 40,000 given by the AOA for that year. Abt. believed this number would represent a surplus of about 4,000 which is reflected by the density having risen to 12.8 in 2012 vs. 11.5 in 1997 and is now at about 13.4. [Figs. 3, 5].
Methodology:
The law of Supply and Demand is difficult to apply to healthcare and optometry in particular. While “supply” is subject to quantitative assessment, “demand” is difficult to define and measure and requires predicting future levels of care actually sought by the public and changes in the US health insurance system and economy.
In the author’s opinion, too much guess work is required to make other than rough predictions about future demand levels and it is best to project changes in density and ask if they seem congruent with reasonable future demands.
This study examines the past densities of optometrists and projects future densities using expected 2018 enrollment rates and future rates of population growth.
The Abt. Report projected a future surplus that would peak just over 4,000 for a 5-year period around 2015 [Figure 5] and assumed graduation rates would remain at 1,127. That prediction appears accurate since D in 2014 has risen from 11.5 to 13.4, a little higher than Abt. predicted because graduation rates had risen above the 1,127 Abt. predicted would remain constant. This means that a surplus now exists larger than Abt. predicted.
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