A new report by Deloitte Access Economics (DAE), commissioned by Specsavers, has warned optometry is currently in the midst of a worsening undersupply crisis.
Despite the new optometry courses on offer, and subsequent higher numbers of graduates, it is predicted that in 20 years’ time Australia will be more than 1,000 full time equivalent optometrists short of meeting the nation’s requirents.
DAE’s new report, Optometry Workforce Report: 2018-2037, also identifies specific shortfalls in supply across several demographics. Levels vary greatly between states and regions, although deficiencies in regional and less densely populated areas are predicted to be particularly acute. The country’s biggest states are also expected to suffer shortages.
“The most populous states such as NSW and Victoria will likely see a shortage of optometrists over the next two decades,” the report reads.
“The ACT will likely enjoy a surplus of optometrists, and although the ACT is tiny, it does have a high population density. The more rote and/or sparsely populated states such as Tasmania, WA and the NT may already have an undersupply of optometrists, and this will continue to worsen.”
The report continues the long-standing debate surrounding the appropriate number of optometry graduates required to meet Australia’s needs. In March, alongside a substantial increase in its graduate intake, Specsavers warned there is still significant competition among employers for new optometrists entering the workforce.
Subsequently, the optical chain was unable to find graduates to take positions at 75 of its stores.
Currently, the company requires an additional 120 optometrists to fill vacancies across its network.Conversely, Optometry Australia (OA) has previously cautioned there are currently too many graduates entering the industry. In November 2018 it was revealed that the number of registered optometry students had soared 28% over the previous 12 months. At the time, OA told Insight that the organisation’s projection research indicated the profession was close to the optimum level of practitioner supply, particularly across the country’s eastern states.
Inarguable is the fact that demand for services is increasing as Australia’s population ages and ocular problems become more prevalent, requiring a greater level of optometric care.
Changing demographics
DAE’s expansive report examined the forces that drive both supply and demand in optometry services. Outside of the expected increase in population, the country’s increasing number of optometry schools is prompting more graduates to enter the workforce. Subsequently, practitioners under the age of 35 are predicted to account for a greater proportion of the profession in the future. On the side of patient demand, Australia’s ageing population results in more eye problems, requiring more services and practitioners.
Despite the increasing number of graduates, demand is still expected to outstrip supply. This is attributed to not just a shortage of optometrists, but the sector’s changing demographics.
DAE’s analysis found that women now make up a slightly larger proportion of the profession than men, though men still supply a greater number of clinical hours to the market due to women being more likely to take short-term leave.
The report predicts women will represent a far greater proportion of the future workforce, reducing the average number of clinical hours worked per optometrist and further exacerbating supply issues.
Ultimately, DAE’s analysis cautions that by 2037 Australia will fall 1,188 full time equivalent optometrists short of meeting the country’s needs.
DAE also addressed OA’s previous reports that suggest Australia is currently close to oversupply. A point of difference between the two reports is that DAE calculated the time needed for procedures as longer than the estimates used in the OA-commissioned reports.
This lengthier estimate, as well as differing methodology, is the source of the significantly divergent forecasts.
Market needs
Mr Charles Horner, communications director at Specsavers Australia, told Insight the report was commissioned in order to understand how the sector is changing.
“In a profession that has seen remarkable growth in the past 10 years, almost tripling in size, it’s important that we have a good handle on what the current and future optometry workforce looks like, because we know that population growth is going to further increase demand for eye tests,” Horner said.
“Optometry needs to be ready to meet that increase in [practitioner] demand and this report helps us to plan on behalf of our store partners, who want to know where the next generation of optometrists are coming from and in what numbers.”
The report’s findings are expected to help inform Specsavers’ decisions for the future.
“By commissioning this report from the experts in workforce modelling at DAE we get to see a clear picture of the future,” Horner said. “This helps us to make a call on whether to get behind optometry schools growing or reducing their student numbers and it is quite clear from this report that we need to get behind a growth in student numbers for the foreseeable future.”
Illustrating the current situation of undersupply, Horner said the abundance of career prospects that young graduates face as they enter the workforce is telling.
“In our own network of 330 Australian practices we took on over 150 graduates last year – but wanted to take on many more. Competition for signatures right across the industry meant we couldn’t. Add to this the fact that optometry graduates are the most highly-paid graduates in Australia and one gets to quickly understand that there is a shortage in the market that we need to address.
“For young optometrists of course it’s a wonderful position to be in, to have real choices and options on where to practice in a profession that is in great health.”
Automated care
In addition to its analysis of the workforce, DAE also examined the potential financial return of programs designed to address specific eye conditions.
Two possible initiatives were investigated: a program to address vision problems in country areas that can be corrected with spectacles, and the nation-wide rollout of optical coherence tomography (OCT).
For conditions that can be addressed with spectacles, the report examined the cost and benefit of gradually increasing the per capita ratio of optometrists in country areas. The estimated cost of a visual impairment case was estimated to be $15,285 in 2018, while the cost of a country optometrist was $327,000 per year. This makes the benefit to cost ratio of placing additional optometrists in country areas as 5.1 to 1.
In the second scenario the benefits of a nation-wide rollout of OCT machines, and the subsequent improvements that would be gathered from screening for glaucoma, age-related macular degeneration and diabetic retinopathy, were calculated. The cost of these conditions varies greatly and they only affect a small portion of the population, however from a societal viewpoint the benefit to cost ratio of OCT screening was calculated to be 4.65 to 1.
Despite OCT’s high cost, the long-term financial benefits of improved and earlier detection of these conditions results in an economic windfall.
Graduate intake
Concerns about the oversupply of optometrists in Australia have been raised alongside the increase in the number optometry courses on offer.
Fears include that an oversupply of health practitioners could lead to poorer employment conditions and less opportunity for optometrists to utilise the full scope of their professional skills.
Last year when the University of Canberra announced it would introduce a Bachelor of Vision Science course – the sixth in Australia – OA CEO Ms Lyn Brodie said that there would soon be more optometrists than necessary.
“We continue to advocate for government funding of university places to consider community need for optometrists, and are hopeful that recent changes in university funding may st the growth in optometry student numbers.”
“Projections studies we have commissioned suggest we are close to optimal supply currently in the eastern states, and tracking toward greater supply than demand in these regions.
“Whilst anecdotal evidence suggests that some regions that have experienced shortages in the past may now have improved access to optometric care, we know some communities rain without the optometric access they need. There rains a need to incentivise and support optometrists to practice in regions of identified need.”
This latest DAE report is the firm’s third since 2006, and illustrates a stark contrast between the measurements of supply and demand across the profession.
