Build It And They Will Come! Oh My, They’re Already Here.
By Arthur De Gennaro

The often used phrase in the first half of the title of this article is taken from the movie,
Field of Dreams, in which Kevin Costner, hearing voices and interpreting them as a
command, builds a baseball diamond in the middle of a rural Iowa cornfield. People not
familiar with the circumstances considered this to be foolish. Analogously, ophthalmology
is being asked to do something similar these days.

The American Academy of Ophthalmology has recently published three white papers
under the title, The Boomers Are Coming! The Boomers Are Coming!1 To torture the
movie references a little further, this is a take off on a movie titled, The Russians Are
Coming! The Russians Are Coming! in which the members of a New England town
become convinced they are being invaded. In a sense, we as a profession are being

The first baby boomer turned 60, two years ago. This is a significant demographic event
because, as the study points out, 80 million baby boomers will become Medicare eligible in
2011. The eyes of some people in this significant demographic group are beginning to
become ‘sick’. This means that they are already beginning to present at ophthalmology
practices; hence the second half of the title above.

The white paper also points out that the number of ophthalmologists is not expected to
rise. In marketing terms, ophthalmology is being asked to handle a substantial increase in
demand, with a static amount of supply.

There are numerous implications of these facts. From a dispensary standpoint, some of
them are:

A greater need for efficiency. Practices will need to see more patients in an hour than they
currently do. This means changing the way ophthalmologists currently see patients; that
is, more delegation.
Increased use of optometrists. Hiring ODs to see patients who require only routine vision
examinations and those requiring post operative follow ups would take these classes of
patients off an ophthalmologist’s schedule. Since 40% of the routine vision examinations
performed in the U.S. are performed by ophthalmologists2, this would significantly
increase capacity.
Increase dispensary size. The input of a dispensary is the output of the medical practice
that supports it. As patient demand and practice throughput rise, so will the demand for
dispensary services.
One stop shoppers. One psychographic characteristic of baby boomers is that they were
raised as ‘one stop’ shoppers. Their purchasing patterns are highly influenced by
convenience and they consider their time to be valuable enough to trade dollars for it. This
is attested to by the capture rates of patients who purchase their eyeglasses at private
optometry offices and commercial chains; the outlets where these customers currently
purchase, (85% for the former3 and nearly 100% for the latter.)
Conspicuous consumers. Baby boomers have very different buying habits than their
parents who were raised during the Depression. Boomers are known for spending money
on high-tech consumer products and fashion merchandise, which includes as eyeglass
lenses and frames respectively. As a result, I expect the sell-through of these items to rise as
a percentage of customers seen.
Need for better trained opticians. Opticians will be asked to work with customers who are
more savvy. This will require them to know more about the features, advantage and
benefits of the products they offer and to be able to help customers select frames that will
enhance their appearance. This will only be possible if the opticians are well trained in
sales and fashion dispensing techniques.
Bigger will be better. No one expects reimbursements to rise. Efficiency can come from the
economies of scale that larger practices and larger dispensaries can provide.
Considering the above, it would seem like the time for action is now; after all, the
‘Russians’ are already coming to ‘play baseball’ in the ‘cornfield.’