Critique finds ‘spurious conclusions’ of optometric manpower surplus

The critique was commissioned by Specsavers following publication of a journal article (Healy, et al, 2015) claiming there is currently a surplus of optometrists in Australia and that the surplus will increase over coming decades..
The 15-page critique was prepared by Deloitte Access Economics, which has a special unit that deals specifically with health workforce issues, and covers ‘six fatal flaws’ that affect the validity of the Healy paper..
The critique says:.
– The start point of the projections incorrectly assumes oversupply of optometrists in 2011, contradicting Health Workforce Australia (HWA) findings that 92.7% of optometrists in 2012 were working in clinical optometry and others in related areas, unployment was low (0.4% of the labour force) and average hours worked were increasing slightly – all indicators of a tight labour market. .
– The conversion from headcount to equivalent full time optometrists (EFTOs) for male optometrists does not accord with real world data and overstates supply. Healy et al (2015) assume that the average hours worked by male optometrists is 42 hours per work week, whereas data from Specsavers (which represents 17% of the Australian optometry workforce) show the average male works 36.2 hours per week. This factor alone represents a 16% overstatent of (males’) supply. .
– EFTOs are derived differently for each side of the dand-supply equation, which also causes overstatent of supply relative to dand. EFTO estimates are based on clinical hours worked on the dand side, but on total hours worked for supply. .
– The analysis does not take into account changing workforce characteristics which again overstates supply. The average age and proportion of women in the optometry workforce is increasing. Older workers and women work fewer average hours, so future hours per optometrist is lower than projected by Healy et al (2015). .
– Dand is understated, projected as straight line growth, based on an assumption that Medicare-funded optometry services will be no higher per capita in 2036 than in 2011-12 (with scenarios at less than 1%pa per capita higher). In reality, dand for health services is income elastic, meaning people consume more with increasing income over time, and as new technologies become available to correct vision loss, as well as due to dographic ageing factors alone. The article’s simplistic analysis does not account for these important income and technology drivers. .
– A final concern is lack of transparency. There is limited discussion of some key inputs, making it unclear how conclusions were derived. This is contrary to best practice modelling approaches, and makes it difficult for a peer review type assessment of the work to be undertaken through or replication/validation. .
The article concludes there is no shortage of optometrists, in stark contrast to recent other higher quality workforce analysis by HWA (2014) and by Deloitte Access Economics (2011), which support earlier assessments of ongoing optometry workforce shortage. .
Workforce projections are an important tool for workforce planning and require accurate, transparent projections. If policymakers make decisions based on overstated supply or understated dand, such as these projections made by Healy et al (2015), there could be serious impacts on wellbeing for Australians.