There are three productivity models for the Australian Optometry workforce.
The first is the Low Productivity Model. This is the model that has been assumed by the 3 most influential papers on the workforce: Horton et al (2006), Access Economics ( 2006) and Keily et al (2008).
This model assumes a 30 min consult requires an additional 15 mins of admin work to complete. It is my contention that most practitioners do not work according to this model. There may be a few who practice with no other staff to help them. This would be rare.
The Standard Productivity Model see practitioners with the level of admin support and technology that allows them to comfortably see appointments according to a 30 minute schedule.
There is a High Productivity Model where practitioners work to a 20 min appointment schedule. This is possible if an Optometrist has the right kind of admin and clinical support. If a clinical assistant performs auto refraction, fields screen, tonometry and even increasingly these day fundus photography. This working schedule is less common but certainly more common than the low productivity model in my experience.
I have set up a survey on the optometry forum
Results so far:
25% do 20min consults
75% do 30 min consults
0% do 45 min consults
at the moment n=8
Comments by respondents:
"I have at least 1-2 hours fun per day, however most consultations do take 20 min. It is easy to decrease them further though if you have worked in a busy practice before. "
http://optomforum.com.au/cgi-bin/yabb2/YaBB.pl?num=1217296739
Survey has been going 24 hrs: So far it is looking like my assumption is correct.
The recent paper by Keily et al ( 2008) estimates that around 7 million consultations ( give or take) will need to be performed PA by 2031
Australia needs:
on the Low productivity model (10 per day) 50 per week, 2300PA, 3043 Equivalent Full time Optometrists (EFTO's)
on Standard productivity model ( 16 per day) 80 per week, 3680 PA, 1902 EFTO's
on High productivity model (21 per day) 105 per week, 4830 PA, 1449 EFTO's
Keily et al examines all the nuances of supply and demand, but really the amount of variance in the productivity model assumption simply dwarfs all the other variables.
Its the elephant in the room.
The conclusion I draw from the 2005 paper and now the 2008 paper is that there is a huge overcapacity and consequent underemployment of Optometrists in Australia.
So to say that "there are sufficient Optometrists to meet the needs of the Australian population" is of course true but wouldn't it be more accurate to also add "because there is an over supply of Optometrists".
Sunday, August 3, 2008
Thursday, July 24, 2008
Australian Optometry Workforce: how many is enough?
Is the Australian Optometry Workforce large enough to provide for the eye care needs of it citizens?
Apparently not.
The Department of Immigration has placed Optometry on a list of in demand occupations.
Australia currently has a skill shortage across all sorts of sectors, most notably the resources sector. The mining boom in Western Australia and Queensland has lead to an extreme shortage of skilled and unskilled workers. This is evidenced by the massive inflation of wages for those who work in that sector. This doesn’t just apply to engineers and tradesmen: unskilled workers whose only qualification is a four limbs and a pulse can command AUD$150,000 PA.
Against this backdrop of skills shortages, record levels of low unemployment, and retiring baby boomer is it any wonder that Optometry firms are having difficulty recruiting Optometrists? These are the very firms that have made submissions to Department of Immigration to have Optometry placed on a list of in demand occupations.
But is there really a shortage of Optometrists?
There are certainly no shortage of Optometry businesses. It seems like even the smallest shopping centre has 2 or 3. Larger shopping districts such as Chatswood in Sydney have about 40 practices in a few miles radius of each other.
If there were truly a shortage of Optometrists then patients would have to wait weeks or months to get an appointment. However the average waiting time to get an appointment is about 1 hour.
If we move from the anecdotal to published research then we find that the most recent study, The Australian Optometric Workforce 2005 ( Horton et al) concluded that there was sufficient Optometrist to meet the eye care needs of Australia.
In the study Horton et al (2005) move past the raw numbers to come up with a more refined concept called an Equivalent Full Time Optometrist (EFTO). This takes into account that of the 2700 registered optometrists not all of them work full time. They concluded that an equivalent full time optometrist conducts about 8 examination per day or 1825 per year. They also state that a typical examination takes 45 mins, so that an optometrist would spend 6 hours per day consulting with clients.
So clearly there is spare capacity. But even this spare capacity is understated.
In the Horton et al study there is a fundamental incorrect assumption. They state that typical examination takes 45 mins. They have overestimated the consultation time by a 50%. The average consultation in fact takes just 30 mins, so that the average optometrist spends just 4 hour per day performing consultations.
What does this mean? It means that there are enough Optometrists in Australia to service a population of 40 million, which is double the current Australian population. It also means that half the optometrists in Australia could be run over a by a bus tomorrow and the population would still have no problem obtaining an eye test.
The so called shortage of optometrists is simply an over abundance of optical businesses. Each of those businesses needs an optometrist in order to operate effectively. If you were to look inside the average business you would find an under employed optometrist yawning and twiddling their thumbs waiting for a patient to arrive.
Apparently not.
The Department of Immigration has placed Optometry on a list of in demand occupations.
Australia currently has a skill shortage across all sorts of sectors, most notably the resources sector. The mining boom in Western Australia and Queensland has lead to an extreme shortage of skilled and unskilled workers. This is evidenced by the massive inflation of wages for those who work in that sector. This doesn’t just apply to engineers and tradesmen: unskilled workers whose only qualification is a four limbs and a pulse can command AUD$150,000 PA.
Against this backdrop of skills shortages, record levels of low unemployment, and retiring baby boomer is it any wonder that Optometry firms are having difficulty recruiting Optometrists? These are the very firms that have made submissions to Department of Immigration to have Optometry placed on a list of in demand occupations.
But is there really a shortage of Optometrists?
There are certainly no shortage of Optometry businesses. It seems like even the smallest shopping centre has 2 or 3. Larger shopping districts such as Chatswood in Sydney have about 40 practices in a few miles radius of each other.
If there were truly a shortage of Optometrists then patients would have to wait weeks or months to get an appointment. However the average waiting time to get an appointment is about 1 hour.
If we move from the anecdotal to published research then we find that the most recent study, The Australian Optometric Workforce 2005 ( Horton et al) concluded that there was sufficient Optometrist to meet the eye care needs of Australia.
In the study Horton et al (2005) move past the raw numbers to come up with a more refined concept called an Equivalent Full Time Optometrist (EFTO). This takes into account that of the 2700 registered optometrists not all of them work full time. They concluded that an equivalent full time optometrist conducts about 8 examination per day or 1825 per year. They also state that a typical examination takes 45 mins, so that an optometrist would spend 6 hours per day consulting with clients.
So clearly there is spare capacity. But even this spare capacity is understated.
In the Horton et al study there is a fundamental incorrect assumption. They state that typical examination takes 45 mins. They have overestimated the consultation time by a 50%. The average consultation in fact takes just 30 mins, so that the average optometrist spends just 4 hour per day performing consultations.
What does this mean? It means that there are enough Optometrists in Australia to service a population of 40 million, which is double the current Australian population. It also means that half the optometrists in Australia could be run over a by a bus tomorrow and the population would still have no problem obtaining an eye test.
The so called shortage of optometrists is simply an over abundance of optical businesses. Each of those businesses needs an optometrist in order to operate effectively. If you were to look inside the average business you would find an under employed optometrist yawning and twiddling their thumbs waiting for a patient to arrive.
Subscribe to:
Posts (Atom)