Physician Assistants and Nurse Practitioners in Ophthalmology—Has the Time Come?

• Published in: American journal of ophthalmology Vol. 186; pp. ix - xi
• Main Author: Browning, David J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2018; Elsevier Limited
• Subjects: Age; Berra, Yogi; Bone surgery; Clinical Competence; Humans; Medical personnel; Nurse practitioners; Nurse Practitioners - organization & administration; Ophthalmology; Ophthalmology - organization & administration; Patients; Pediatrics; Physician assistants; Physician Assistants - organization & administration; Population; United States; Workforce; United States > US
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2017.09.023

The number of optometrists has increased from 37 000 in 2000 to a projected 46 300 in 2020, and new programs continue to be developed.6 Whereas the number of ophthalmology residency positions is tied to financial support from the federal government, the number of positions in optometry programs is not, responding only to economic conditions, which have favored expansion. [...]real-world outcomes in the use of anti–vascular endothelial growth factor injections for retinal diseases lag behind those of registration trials, mainly because in real life the regularity of injections drops.14 One factor in the drop is overburdened retina specialists who lack the time and clinic openings to treat based on a fixed schedule. In 1990, the Council on Graduate Medical Education predicted a decreased need for physicians based on the expected effects of health maintenance organizations, which then collapsed.16 In 1995 the RAND report on ophthalmic workforce supply and demand stated “with a high degree of confidence” that through 2010 there would be “a large surplus of eye care providers in the United States.”