Why Can’t We Just Get Along on Board Certification?

Michael Gorman, OD 
Can’t our political representatives stop the ideological bickering and start to listen to us—the majority in the middle class? Sure we all dislike tax increases, fiscal cliffs, loss of favorite deductions, reduced entitlements, etc. But can’t our politicians try the politically incorrect term: compromise? Those politicians should get together and do the work that our votes sent them to do.

Can organized optometry see any lesson from the above analogy as it relates to Board Certification? Now is the time for all reforms to begin a dialogue and debate within the American Optometric Association (AOA) and invite even some moderate outsiders so we can settle the question on Board Certification. The action of some reformers is vociferous and often angry with some talk of breaking away from organized optometry. That would be a shame. Many supporters of Board Certification have made similar threats if they seem to see organized optometry as lacking support for their side. This crisis in our profession must come to an end. Let’s hope we can find a way: Compromise.

Is organized optometry willfully blind to trends and priorities of the wider society of its members, and even non-members, outside organized optometry like: Obamacare, Medicare / Medicaid, 3rd parties that include vision care, Accountable Care Organization, etc.? Why is membership in organized optometry— although it varies—been rather stagnant relative to the increase of newly licensed ODs?

Whatever the motivation the AOA has for supporting Board Certification, whatever the principals it holds up to argue for Board Certification, the fact remains that this decision is not intelligible to our wider society of ODs whether member or non-member. Let us acknowledge that criticism from within AOA has caused many in the association to believe the AOA has lost its broader relevance to its members and maybe even those in the other health care professions. The AOA has failed to achieve reconciliation with the groups who oppose Board Certification. Airing our differences in public court cases after court cases is not the way to have reconciliation—and that applies to all sides concerned.

Let’s hope that all sides do not miss an opportunity to bring us together with honest compromise, not dividing us with statements based on an unchallengeable position. Compromise doesn’t mean we won’t have any problems. It means solving problems, without pointing a finger at each other.

Organized optometry should think about how to build a more meaningful role for optometric care as we are presently licensed to do. That would be a greater benefit to all members and non-members. This is a clear, simple request, though difficult to implement: compromise. We need individuals on all sides to come together, speak out and be part of the solution. We must settle this issue before it damages our profession and our organizations that lead us at the state and national levels.

Are there comparisons between AOA and the American Medical Association (AMA)? The AMA membership has declined since the 1950s (from 75 percent physician membership to 15 percent in 2011). The AMA’s power stems from its political clout on Capitol Hill and a money-tinged relationship with the larger sector of the health care system, such as insurance companies and the pharmaceutical / medical device industry. Can you see any comparison to what the AOA is doing today? For the good of our profession we hope not.

But the lesson to learn from AMA /AOA comparison is that: divisiveness leads to division, division leads to separation and separation leads finally to disintegration. We don’t have to go there! Does the AMA speak for all physicians? No, but more importantly, do the AOA policies represent the majority of ODs, even those who are not members? Probably not! So until the AOA hears from the majority (member and non-member) of all of us, it becomes extremely important to let the AOA know where you stand on Board Certification. I hope you all recognize that we are all going down the same road together riding in the same car together. So until some of you ask to slow down or even stop the car so we can all see where we are being taken, compromise will never be achieved.

—Michael Gorman, OD

Michael Gorman, OD is in private practice at Family Vision Centers in Stratford, Conn. He can be reached at famvision@aol.com.