In 10 years, will optometry as we know it still exist?

Will optometry be overwhelmed by AI technology?

 Kodak was once the dominant player in the global camera film and photographic paper markets. The board ignored the warning coming from middle management that the digital technology threat was imminent, and three years later, in 2012, the company filed for bankruptcy. The rise and fall of Kodak serve as a cautionary tale about the importance of adapting to technological advancements and being open to innovation in a rapidly changing business environment. Online shopping in South Africa was estimated to be around 2-3% five years ago. Today, it is an obvious and massive reality. Can you remember the last time you entered a bank? 

The refractive error

Refraction is particularly susceptible to obsolescence. Few argue that refraction and the management of refractive error remain the defining features of optometry in South Africa. Unfortunately, the scope of optometry in South Africa has stagnated compared to optometry in the USA, where it has expanded into a much wider field of diagnostics, therapeutics, and clinical procedures. This makes our profession more vulnerable. Is there a future for human-performed refraction against the backdrop of the rapid inroads of Artificial Intelligence (AI)? What seemed far-fetched yesterday is a reality today. One can imagine an automated refraction system delivered through a smartphone and linked to an advanced 3D printer that spits out spectacles instantly. Automated kiosks for refraction and dispensing are a reality, and online vision testing has also arrived. Diagnosis of pathology is primarily based on imaging and differential diagnosis, and will be more accurately performed by  AI. At some point, consumers will turn their backs on optometry because they can obtain reliable, affordable optometric care through new-age technology. Prescribing skills will not save practitioners from advances in technology. In its most basic form, refraction is an algorithm. There is a grave danger in relying solely on refraction and ocular disease detection as the primary offering, expecting patients to show up.

Business as usual?

Shopping habits are shifting from malls to online platforms, where everything is available and delivered to the doorstep. Communicating across all social media platforms has become a fine art and is very effective. Today’s consumers tend to judge businesses by their online presence. AI-powered tools can optimise patient scheduling, manage inventory, and provide performance analysis, increasing efficiency within the practice. AI can automate repetitive tasks, such as data entry and image analysis, as well as electronic record-keeping, freeing up optometrists to focus on personalised patient care. 

Today’s consumer is more enlightened (thanks to Google) and mostly addicted to the internet in one way or another. The pace at which consumer behaviour has changed in just a few years is astonishing. The real danger is not recognising the change in the business landscape and perpetuating business as usual.

The digital opportunity

Creating awareness of products and services through a long-term advertising campaign was once out of reach for small businesses due to its prohibitively high cost. On the bright side, digital technology has opened the door for optometric practices to reach patients through advertising and communication at an affordable price. Social media platforms have become an integral part of everyday life. Those practitioners who have embraced digital technology as a marketing tool and a means of patient communication are getting a head start.

Emotional labour – our saving grace?

People define products and services just like a chef can define a restaurant.

The good thing is that emotional labour is beyond the scope of AI. Diagnosis is not the same thing as care. AI can increase access, enabling everyone to receive a diagnosis; however, the care still requires human interaction, empathy, and understanding. 

In any job that involves dealing with people, the key to success is being nice and making people feel good. This can be labeled as emotional labour, a phrase coined by sociologist Arlie Russell Hochschild in her book The Managed Heart: Commercialization of Human Feeling (1983). It involves suppressing undesirable feelings and displaying or cultivating desired ones when dealing with people in the workplace. Even when feeling miserable! This is what we do as optometrists, whether willingly or unwillingly; yet, most of us do not have a tangible measure of how emotional labour can impact our clinical journey.

Emotional labour is the act of managing your emotions and outward emotional expressions to meet the demands of a job. The capacity for emotional labour is not an inherent characteristic that everyone is blessed with, and it is not infinite; however, it is incredibly powerful. It is what will make patients ask for you as a professional and choose you over AI technology. Surprisingly, the concept of emotional labour is not commonly recognised by optometrists. A future in which computers replace the intuitive and empathetic skills inherent to humanity is not envisioned, at least for now. Eye care remains a highly human endeavour, involving emotional labour. The moral of the story is that AI will be better at some things than we are, but we will be better at some things than AI. Whether AI will replace clinical optometry is questionable, but clinicians who use AI-driven technology will replace those who don’t. Clinicians who understand and embrace emotional labour, will be at an advantage.

The culture of emotional labour

The application of emotional labour begins with recognising it for what it is and fostering a culture of positive emotional labour within a practice. It can be as simple as taking eighty-year-old Aunty Agnes by the arm to lead her into the consulting room. Likewise, managing the process of adapting to spatial distortion due to a significant refractive change is beyond the scope of AI, but within the ambit of emotional labour. It is not uncommon to go on the defensive when a patient checks in, unhappy with the new spectacles. Under the mantle of ‘positive emotional labour’, the first words should be: “ I just want you to know, we will do whatever it takes to make you love your glasses, and it won’t cost anything.” This sets the stage for a positive outcome and a long-term relationship.

Practical applications of emotional labour

Hello, Who Are You?

HWAY is based on the simple concept that for us to consider all visual solutions, we need to know a lot more about our patient. The concept: Once we know, by the patient’s own admission, that they are involved or participate in a particular activity, we can enhance performance by offering the best visual solution for the task. - Read more

Grab a heart

Patients, as a rule, attach great importance to the fact that their optometrist is familiar with their ocular history. Grab a Heart is a powerful module that capitalises on this emotion. - Read more

Frame alignment  

Word-of-mouth referrals are the largest source of new patients and depend entirely on the customer's ultimate evaluation of what we have delivered to them. This means the evaluation of the spectacles over a two-year period in terms of:

• Look good
• Feel good
• See good

To feel good, the spectacle frame needs to be properly aligned to the face – Read more 

Domiciliary visits

Taking the trouble to go visit a patient's place of work is a prime example of emotional labour, being extra caring. The proper ergonomics of the visual task can now be assessed firsthand and, moreover, made visible to all. Examples - Read more

Running late

One of the most unpleasant experiences in healthcare occurs in a doctor's waiting room when he is running an hour late, and you have no idea how much longer you will have to wait. - Read more

Real Need

Understanding a patient’s real need does not only imply acknowledging the Chief Complaint, but rather the underlying cause of the chief complaint. As humans, we often introduce a request with a pseudo need. - Read more

Emotional labour extends beyond the consulting room

Your patients will have a lot of respect, trust, and think you are caring and clever, if you demonstrate that you understand the environment and terminology of the sporting or hobby world they love. For example, what goes on at a lawn bowls match? What are the visual challenges, considering players are generally of advanced age?

Take the test below to see if you can relate the key words to the relevant sport or hobby.

Emotional Labour