Oversupply of Lawyers, Oversupply of Lawyers, Optometrists and PharmacistsOptometrists and Pharmacists

Same Cause and Same Cause and ConsequencesConsequences

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““The Perfect Storm” The Perfect Storm”

Too Many Schools and Graduates Too Many Schools and Graduates

Declining Employment Declining Employment

Decline in Admissions Decline in Admissions ApplicantsApplicants

Viability of Some Schools Viability of Some Schools ThreatenedThreatened

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The Rapid Increase in GraduatesThe Rapid Increase in Graduates

Law SchoolsLaw Schools Opened 19 New Law Schools Since 2000 Opened 19 New Law Schools Since 2000 • From 186 to 205 Schools in 15 years-More Planned From 186 to 205 Schools in 15 years-More Planned • Over 40,000 Graduates AnnuallyOver 40,000 Graduates Annually

Optometry Schools and CollegesOptometry Schools and Colleges Opened 7 New Optometry Schools From 2008 to 2017 Opened 7 New Optometry Schools From 2008 to 2017 • From 17 to 24 Schools in 8 Years (a 41% Increase)From 17 to 24 Schools in 8 Years (a 41% Increase)• Increased Enrollents at Some SchoolsIncreased Enrollents at Some Schools• 500 Entering Seats Added500 Entering Seats Added• Increase in Graduates: 1127 in 1997 to 1600 in 2014, Increase in Graduates: 1127 in 1997 to 1600 in 2014,

Could Reach 1900 by 2020. Could Reach 1900 by 2020.

The Rapid Increase in GraduatesThe Rapid Increase in Graduates

Pharmacy Schools and Colleges Pharmacy Schools and Colleges

48 New Schools in 14 years: 82 to 130, 48 New Schools in 14 years: 82 to 130, 58.5% Increase58.5% Increase

269,900 Pharmacists in 2015269,900 Pharmacists in 2015

8,000 Graduates in 2003 to 14,000 in 20158,000 Graduates in 2003 to 14,000 in 2015

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Oversupply of LawyersOversupply of Lawyers

Number of Lawyers Tripled Over Last 35 Number of Lawyers Tripled Over Last 35 Years While US Population Increased Just Years While US Population Increased Just 40%40%

Increase From 404,000 to 1.22 Million Increase From 404,000 to 1.22 Million Lawyers in US During This PeriodLawyers in US During This Period

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Oversupply of OptometristsOversupply of Optometrists Rand Corp-1995, Abt Assoc-2000 and Lewin Report-Rand Corp-1995, Abt Assoc-2000 and Lewin Report-

2014 All Indicated Surpluses of Optometrists2014 All Indicated Surpluses of Optometrists Lewin Study Indicated Current Lewin Study Indicated Current 30%30% Excess of Excess of

Optometrists or Optometrists or 12,672 FTE12,672 FTE 30,000 30,000 in 1997 (S=D) in 1997 (S=D) to 40,000 Optometrists to 40,000 Optometrists in in

20152015 Myers Density Study: 11.5 Optometrists per 100,000 Myers Density Study: 11.5 Optometrists per 100,000

in 1997 to 12.8 in 2015. When All New Schools are in 1997 to 12.8 in 2015. When All New Schools are Fully Operational, Density Will Peak at 17.0 Fully Operational, Density Will Peak at 17.0 Optometrists per 100,000.Optometrists per 100,000.

However, Bureau of Labor Statistics (BLS) Projects However, Bureau of Labor Statistics (BLS) Projects 11,000 FTE Additional Optometrists Needed by 202411,000 FTE Additional Optometrists Needed by 2024

• Inconsistent With All Previous Manpower Studies Inconsistent With All Previous Manpower Studies

Oversupply of PharmacistsOversupply of Pharmacists

25% Oversupply Predicted by 201825% Oversupply Predicted by 2018

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Consequences of Oversupply On Consequences of Oversupply On Employment Employment

LawyersLawyers Underemployment and Unemployment of GraduatesUnderemployment and Unemployment of Graduates• 45% of Graduates Unable to Find Full Time Positions45% of Graduates Unable to Find Full Time Positions• Compensation Has Declined to Median Starting Compensation Has Declined to Median Starting

Salary of $61,000Salary of $61,000• Top Schools Employ 3-17% of Their Own GraduatesTop Schools Employ 3-17% of Their Own Graduates Optometrists Optometrists Full Time Positions Difficult to FindFull Time Positions Difficult to Find Recent Graduates Practice in Multiple LocationsRecent Graduates Practice in Multiple Locations Lewin 2012: 46% of Graduates under 30 yrs. Lewin 2012: 46% of Graduates under 30 yrs.

Practice at Two or More Part Time Locations, 11.5% Practice at Two or More Part Time Locations, 11.5% at 4 Locationsat 4 Locations

Consequences of Oversupply on Consequences of Oversupply on Employment Employment

PharmacistsPharmacists Some Graduates Can Only Find Some Graduates Can Only Find

Employment as FloatersEmployment as Floaters Oversupply is to Drug Chains’ Advantage Oversupply is to Drug Chains’ Advantage

by Forcing Pharmacists’ Income Downby Forcing Pharmacists’ Income Down

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Consequences of Oversupply on Consequences of Oversupply on Law SchoolsLaw Schools

Applicants Down 37% and Enrollment Applicants Down 37% and Enrollment Down 24% Since 2010Down 24% Since 2010

• Less Qualified Students Being Admitted Less Qualified Students Being Admitted with LSAT Scores Less than 145. with LSAT Scores Less than 145.

• Declining Pass Rate on Bar Exam: Lowest Declining Pass Rate on Bar Exam: Lowest in 13 Yearsin 13 Years

• Only 46.6% Passed in CaliforniaOnly 46.6% Passed in California• Misrepresentation Law Suits by Misrepresentation Law Suits by

Students/Graduates Students/Graduates • Faculty/Staff Layoffs, Some Law Schools Faculty/Staff Layoffs, Some Law Schools

Consolidating or May Close. Consolidating or May Close.

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Consequences of Oversupply on Consequences of Oversupply on Optometry Schools and CollegesOptometry Schools and Colleges

Only 1.5 Applicants per Entering Seat: Less Only 1.5 Applicants per Entering Seat: Less Than 1.5 Are Qualfied for AdmissionThan 1.5 Are Qualfied for Admission

Applicants Apply to an Average of 5 Schools Applicants Apply to an Average of 5 Schools • Small Positive Changes in Applicant Pool in Small Positive Changes in Applicant Pool in

Recent Years Are Quickly Absorbed by New Recent Years Are Quickly Absorbed by New SchoolsSchools

Admissions Standards Vary Significantly Admissions Standards Vary Significantly Among Optometry Schools and Colleges:Among Optometry Schools and Colleges:

Entering GPA 3.61 to Entering GPA 3.61 to 3.183.18 Mean Science OAT 350 to Mean Science OAT 350 to 287287 Pass Rate on NBEO Also Varies: 100% to Pass Rate on NBEO Also Varies: 100% to 77%77%

Consequences of Oversupply on Consequences of Oversupply on Pharmacy Schools and CollegesPharmacy Schools and Colleges

Applications for Admission Down 8.1%Applications for Admission Down 8.1%

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Actions to Mitigate the Effects of Actions to Mitigate the Effects of Oversupply of OptometristsOversupply of Optometrists

Comprehensive ApproachComprehensive Approach

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Optometry Schools and CollegesOptometry Schools and Colleges

Decrease EnrollmentsDecrease Enrollments

Consolidations and AfilliationsConsolidations and Afilliations

Modify CurriculaModify Curricula

CMS ComplianceCMS Compliance

Control Student DebtControl Student Debt14

Decrease EnrollmentsDecrease Enrollments

Reduce Entering Class Size and Overall Reduce Entering Class Size and Overall EnrollmentsEnrollments

Consolidation of Schools and CollegesConsolidation of Schools and Colleges Additional Educational Offerings in High Additional Educational Offerings in High

Demand Health Care Professions for Demand Health Care Professions for Private CollegesPrivate Colleges

Pursue Innovative Programs/Affiliations Pursue Innovative Programs/Affiliations with Health Sciences Centers and with Health Sciences Centers and Universities for Private SchoolsUniversities for Private Schools

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Curricula ModificationsCurricula Modifications

Make An Optometry Career More Attractive Make An Optometry Career More Attractive and Control Debt by Shortening the Overall and Control Debt by Shortening the Overall Length of Education for O.D. Length of Education for O.D.

• In the Process, Develop a Clinical Training In the Process, Develop a Clinical Training Model to Potentially Qualify for $12 Billion Model to Potentially Qualify for $12 Billion GME ProgramGME Program

• Training Model Would Permit Current 4Training Model Would Permit Current 4thth Year Year Students (Who Become Residents) to Students (Who Become Residents) to Contribute to Billable Services and Receive Contribute to Billable Services and Receive Stipends.Stipends.

• Current Student-Centered Training Model Current Student-Centered Training Model Vulnerable to Violations of CMS RegulationsVulnerable to Violations of CMS Regulations

Profession of Optometry Profession of Optometry ResponsibilitiesResponsibilities

Accreditation ActionsAccreditation Actions

Aggressive/Consistent Federal Aggressive/Consistent Federal AdvocacyAdvocacy

Correct BLS ReportCorrect BLS Report

Publish an Employment IndexPublish an Employment Index17

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Profession’s ResponsibilityProfession’s Responsibility

Do Not Accredit New Schools of Optometry Until Do Not Accredit New Schools of Optometry Until There is a Market Correction to the Supply and There is a Market Correction to the Supply and Demand of Optometrists: Currently, there is Demand of Optometrists: Currently, there is 12,765 12,765 FTE SurplusFTE Surplus

In the Future Accredit New Schools to a Maximum In the Future Accredit New Schools to a Maximum Enrollment Enrollment

Seek Inclusion of Optometry in Federal Programs: Seek Inclusion of Optometry in Federal Programs: GME, National Health Service Corps, Scholarships, GME, National Health Service Corps, Scholarships, Loan Forgiveness and Practice Start-Up Support Loan Forgiveness and Practice Start-Up Support

Require Explanation and/or Correction of Bureau of Require Explanation and/or Correction of Bureau of Labor Statistics Projections -Rationale for New Labor Statistics Projections -Rationale for New SchoolsSchools

• Develop and Annually Publish an Index of the Develop and Annually Publish an Index of the NumberNumber of Graduates of Graduates to to Practice OpeningPractice Openings in the s in the Private, Goverment and Commerical SectorsPrivate, Goverment and Commerical Sectors

Increase Demand for Optometric Increase Demand for Optometric ServicesServices

Address Underserved AreasAddress Underserved Areas

Significantly Expand Scope of Significantly Expand Scope of PracticePractice

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Public Health Approach to Public Health Approach to OversupplyOversupply

Increase Demand for Optometrists by Increase Demand for Optometrists by Addressing Need for Eye Care in Inner-Addressing Need for Eye Care in Inner-City and Rural AreasCity and Rural Areas

• 3,278 FTE 3,278 FTE Needed in Community Health Needed in Community Health CentersCenters

Only 20% of Federally Qualified Only 20% of Federally Qualified Community Health Centers Offer Community Health Centers Offer Optometric ServiceOptometric Service

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Lewin Study Suggested Actions to Lewin Study Suggested Actions to Decrease SurplusDecrease Surplus

Lewin Projects a Decrease in Current Optometry Lewin Projects a Decrease in Current Optometry Surplus of Surplus of 12,672 FTE 12,672 FTE to to 4,400 FTE 4,400 FTE by 2025by 2025

• IfIf Optometrists Provide the Same Scope of Optometrists Provide the Same Scope of Practice As OphthalmologistsPractice As Ophthalmologists

• And 1.36 FTE OD Surplus Fill 1.0 FTE MD And 1.36 FTE OD Surplus Fill 1.0 FTE MD ShortageShortage

However, Management of Diabetic and Elderly However, Management of Diabetic and Elderly Patients with Multiple Medical Problems Requires:Patients with Multiple Medical Problems Requires:

• Advanced Clinical TrainingAdvanced Clinical Training• And Legal Authority in All States to Treat With And Legal Authority in All States to Treat With

Systemic Medications and Perform Invasive Systemic Medications and Perform Invasive ProceduresProcedures

• Acceptance of Optometrists Providing These Acceptance of Optometrists Providing These Procedures by Insurance Carriers is NecessaryProcedures by Insurance Carriers is Necessary