What can the trend toward Virtual Primary Care teach Optometry?

12th May 2021

Last week I received a letter in the mail from my insurance provider telling me about my Teledoc benefit.  I recognized the envelope; I get the same letter every month since I signed up. Inside was a list of the conditions for which I can use telemedicine. Headaches, sore throat, flu, skin rash and more. It makes sense that they are promoting it so strongly, it’s less costly to them to cover a telehealth visit versus an ER or Urgent care visit. I’m not sure if they know this but I don’t have a primary care physician, so I very well could end up in one of those types of clinic. Plus, if they are really doing their homework on me as working mom of 3, I am the ideal patient for this option. Convenience is king in my world. Make my life easier and I’m all in.

My insurer is not the only one partnering with telemedicine companies. All major US carriers offer telehealth coverage on some level. Recently United Healthcare (UHC) announced they are expanding virtual options with new options for primary care. This initiative through Amwell is initially available to members in 11 states, they plan to add more states in 2021.  Virtual primary care allows members to virtually establish a relationship with a PCP (primary care provider) for preventative, routine, and follow up care. United Healthcare is not alone in this move. Cigna, Humana, Teladoc and Amazon are all also expanding its virtual primary care options.

I would imagine this elicits strong opinions from providers of any specialty but especially from eye care providers. After all, optometry is primary care for eyeballs. Will this happen to optometry too? Will we see vision care plans aggressively offer tele-optometry for annual eye exams to its members? What will this mean for ECPs in bricks-and-mortar practices?

Before we go down a spiral of what-if scenarios, it’s important to understand why United Healthcare and others are expanding into virtual primary care in the first place. UHC sites two main reasons. Firstly, there has been a decrease in the number of Americans with a primary care physician, with an estimated 25% of people lacking a PCP. 1 As previously mentioned, I’m over here with my hand raised.

Secondly, patients prefer it. In a recent United Healthcare Survey, 56% of respondents said they use virtual care for medical services. Even more compelling is the fact that 25% of patients responded that they would ‘prefer’ a virtual relationship with a primary care physician rather than in-person visits. I’m also raising my hand to this. The thought of establishing a relationship with a primary care physician virtually sounds appealing to me. It takes time to find a PCP who is accepting new patients, plus the appointment itself would likely take at least 2 hours out of my day. But there is a caveat, I’d want to make sure that PCP also has a local office to visit if needed.


So, do we see similar trends in eyecare? According to Jobson’s Covid ECP study in March 2021 patient volume was down 8%. With additional time dedicated to cleaning taking up clinic time and reduced staff support, ECPs are not yet operating at full capacity. And according to a 2018 study by VSP Vision Care and YouGov, only half of respondents get an annual eye exam. So, on the first point, the trend is similar.

In eyecare less patients are being seen. And what about the second point, do patients have a preference for virtual eyecare?

The answer is a resounding yes according to the results of the annual Vision Wellness Study by Versant Health released in February 2021. 67% of respondents say that virtual visits would make them more likely to make an eye doctor appointment. When you look at respondents under the age of 40, the number jumps to 74%. In addition, 38% of people under 40 say that being able to communicate remotely with eye doctors would have a high impact on seeing an eye doctor more often. And it’s important not to ignore that 15% said they might not visit an eye doctor as often as they would like if they do not yet offer virtual visits. Let that sink in for a minute. 15% of your patients delaying care or worse choosing another provider because of something you do not offer.


Now that we’ve identified that the trends are similar, what can an eyecare provider do to stay ahead of what is happening in primary care?

For one, don’t assume your patients do not want virtual options just because they have not asked. Have you asked them? Conduct a survey to find out if they’d want the option. You might be very surprised by the results. Also consider that many people in your community, who are not your patients yet, would prefer telemedicine options. Some people think getting eyecare is too difficult and seek online options instead.

Secondly, be proactive. Don’t let insurance carriers dictate what happens in this space. Research the different telemedicine options available and find the one that aligns with your values and goals. The tele-optometry options available to ECPs range in robust to light. From comprehensive eye exams to remote monitoring. Ask yourself how committed you are and what capacity do you have to take on something new.  Some telemedicine options feel so different from what you are doing now it can feel overwhelming. But there are other options, like AOS (Advanced Ophthalmic Systems) that allow you to make smaller incremental changes. Like starting small by doing consultations, or follow up visits, virtually instead of in office. By making smaller changes, one step at a time, you will build confidence in offering virtual care. Confidence breeds creativity. You will start to look at your schedule and see more and more possible ways to offer virtual care to patients. And in the end, you will see it’s a win/win for all.


Telemedicine is here to stay and the move toward virtual primary care by major insurance carriers is a clear sign that it’s not to be ignored.  It’s not to be feared either. Most agree that the best way to use telemedicine is in a hybrid model. One that blends virtual care options with an in-clinic experience.  Giving the patient convenience without sacrificing clinical excellence and continuity of care.


Allison Granger – VP Business Development – North America


  1. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2757495?resultClick=3