2009.04.23 22:37:08

John McDaniel

Attention: Wisconsin Optometric Association Board Members

I am writing to formally submit my opinion of the current joint board certification proposal that is to be presented this June at the AOA Congressional Meeting.  Having served on this board in the past with many of you I am confident that you will understand that I am delivering an opinion only after serious and deliberate consideration.

I have analyzed the proposal from three perspectives: the need for board certification, the real implications of the process on the state of the profession, and the pragmatic ramifications at the individual level.

On the purported need for board certification, I am admittedly divided.  I believe there may some day be a need for a method to assure continued competence but I fail to see the urgency implied by such an aggressive schedule for consideration.  Having held a society meeting on February 17, 2009, I discovered that the topic of board certification was entirely new to most of the members present.  I believe hasty presentation and elucidation of the process will only serve to alienate a non-trivial proportion of American Optometric Association and Wisconsin Optometric Association members.  The future need for a true board certification process is worthy of debate and discussion but only on a more reasonable time scale.  I also believe that the construct of “board certification” is reserved for sub-specialties that deviate from the general practice of the profession.  By definition, what is being sought can not be considered “board certification” with any significant level of cross professional respect.

With regards to the impact the process may have on the profession as a whole I see several aspects that concern me.  First, the process will serve as a means to further divide the field.  There are enough divisions in optometry already including mode of practice distinctions and State-to-State privilege variations.  The inevitable discourse the board certification effort will engender is not worth the eventual benefits.  Second, the board certified designation itself will provide a direct and visible line of demarcation between optometrists.  This division will only serve to provide additional avenues on which to discriminate against a sector of optometrists.  Thirdly, the economic costs of this proposal are exorbitant and far outweigh any proposed benefit.  When such economic costs are attached to a proposal it is only logical to “follow the money” and become cautiously suspicious about those expected to gain from its implementation.  This suspicion may also further divide our profession.

Finally, the individual optometrist has many difficult issues to deal with in day-to-day practice.   In my opinion, the most significant of these issues are access to third parties and the limitations of state-by-state licensure.  While the current board certification process purports to address the third party access issue, I believe the net impact will be negative at best for most optometrists.  The break even point for analyzing the individual costs of the board certification process and the purported increased access to third party plans may well take decades to materialize.  Even that analysis assumes that third parties will not seek an alternative reason to exclude optometrists as providers.

In summary, I am convinced that the current board certification proposal is not in the best interest of optometry, the AOA, or the WOA.  I am asking that the WOA delegates vote “no” at the AOA meeting this June.  If you have any questions regarding my recommendation please do not hesitate to contact me.

Warm Regards,

John McDaniel, OD, MLHR

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