In the jungle that is eye care, opinions on who rules the roost will vary greatly. Ask the American Academy of Ophthalmology, and I imagine they still perceive a massive gap between the two professions. Ask our AOA, and they will likely remind you that optometry is the primary eye care provider in the US and a profession that continues to evolve and expand.

For me, cooperation between the two professions is the bellwether of who’s who in eye care. Professional and personal relationships have dramatically warmed over the past decade, and, as the old guard in ophthalmology moves on, and OD scope increases, the two professions continue on a path of greater similarities than differences.

Yet, despite all of our growth, the typical OD’s self-image continues to lag behind how MDs see and value themselves. I was reminded of this the other day during an intriguing conversation with an industry friend.

Fair Market Value or FMV for short is how most of the health care industry determines what a health care provider’s time is worth. Sadly, when it comes to optometry, most ODs, including some of our most respected and recognizable leaders, are paid much less than their MD counterparts are—for the same services. So, when an OD sits next to an MD at an industry advisory board, the MD may actually be paid two or three times as much as his OD colleague for exactly the same work.

Before you go blaming industry for discriminating against optometry, understand that the issue of FMV is incredibly complicated and mired in the same compliance insanity that spawned the pointless Sunshine Act. Independent consulting firms specializing in FMV have cropped up (big surprise) and determine what an OD’s time is worth. As much as it may sting to hear this, much of the information they base their analysis on comes directly from us. For example, when a typical MD is asked what they would charge to participate in a one-hour interview, their average fee is over $500 an hour. When an OD is asked, it’s about $150.

Yes, ODs and MDs are obviously different, but is an MD speaking at a dinner meeting’s time worth three times what an OD’s is? As much as I value my MD friends and their speaking ability, I don’t think so. Industry partners that have long supported optometry remain supportive, but they often find their hands tied by regulatory imperative and our own poor self-image. This frustrating disparity is slowly being addressed but in the end, it is our uncanny ability to devalue ourselves that has yet again made us our own worst enemies.

Arthur B. Epstein, OD, FAAO Chief Medical Editor artepstein@optometricphysician.com