Preparing to Restart Our Practices

The Governor’s stay at home order concludes on May 3rd and many offices will be preparing to return to what will be our “new” normal practice.  If your office is located in an area where the local government or health departments have more strict stay at home orders, that is the guideline you will follow.

What should we be doing NOW

  • Monitor communications from the AOA, MOA, CDC, state and local (county) health departments.
  • Make a plan for your practice
    • Clinical and non-clinical services
    • Purchasing
    • Staff roles and responsibilities
    • Educate staff on appropriate use of PPE
    • Communicate with local medical offices, surgery centers and hospitals to let them know you are seeing emergent/urgent care patients and will be open to routine referrals on XXXX
  • Prepare your office space
    • Cleaning and sanitizing the office and dispensary
      • Have a process for sterilizing all equipment and materials (frames). Instructions for cleaning VF machines, Optos and OCTs are below
      • Workload plans including opening and closing protocols and cleaning between patients
    • How will you triage patients needing urgent care, normal appointments and rescheduling patients?
    • Rearranging you waiting areas and removing toys and magazines
    • Anticipate supply needs
    • Develop screening protocols for staff and patients
      • Taking temperatures for both
      • Staff showing symptoms of being sick should not be permitted to work
    • Develop a plan to manage patient flow to ensure appropriate physical distancing
      • Waiting area capacity
      • Request patients call or text upon arrival
      • Require that companions remain outside unless patient has mobility issues or needs assistance
      • Establish longer timeframes between patient appointments
    • Post signage regarding new office protocols
  • Scheduling
    • Contact and check on your complex patients: Diabetes, glaucoma, AMD, complex contact lens patients, myopia management
    • Identify patients that were postponed
    • Appointments only, no walk ins when other patients are there
    • Develop scripts for scheduling patients and advising patients of new office protocols
      • Wellness surveys
      • Mask requirement for staff and patients
    • Update your social media to alert patients to reopening and new protocols


2020 AOA President’s Council

Profession’s leaders primed for states opportunities and challenges in 2020

Here’s what happened at the optometric leadership forum:

Moderator Chris Wroten, O.D., uses an early 20th century expedition to the South Pole to inspire attendees at Presidents’ Council, Jan. 16-18, in Houston, Texas. Success isn’t guaranteed through sheer determination alone; effective leaders know it takes a concerted, thoughtful approach that best utilizes the resources available. And that’s not just a maxim.

The Race to the South Pole, an early 20th century pursuit that boiled down to competing expeditions by Norwegian Roald Amundsen and British Capt. Robert Falcon Scott, is a perceptive case study in leadership. Such was the picture that Chris Wroten, O.D., AOA Federal Relations Committee member and Presidents’ Council moderator, painted for nearly 170 volunteer leaders and affiliate staff at Presidents’ Council, Jan. 16-18, in Houston, Texas, as a preamble to the leadership-oriented meeting.

For their parts, Amundsen and Scott couldn’t have more polarizing leadership styles, Dr. Wroten underscored. Amundsen, an accomplished explorer relying on the experience and skillset of his team, meticulously planned his Antarctic expedition but chose a calculated delay when weather posed an unnecessary risk. Scott, an ambitious naval officer, trudged headlong without proper preparations on what would become an ill-fated venture. Ultimately, it cost Scott and most of his team their lives.

“It’s a stark contrast in leadership styles and the resulting outcomes,” Dr. Wroten shared with attendees. “Keen preparation that included seeking and heeding advice from other experienced explorers, as well as paying attention, combined with solid leadership decision along the way, led to success and a safe return for Amundsen.”

Although lives aren’t hanging in the balance, Dr. Wroten’s point on professional leadership resonated among the optometric leaders. Convened annually as an affiliate leadership development and orientation, professional networking and strategic planning opportunity, the Presidents’ Council strives to enhance the effectiveness of volunteer leaders with resources that equip them to help advance the profession, both nationally and at home.

In opening Presidents’ Council, AOA President Barbara L. Horn, O.D., provided several updates on key AOA initiatives and priorities in the new year, including the AOA’s nationwide eye health awareness campaign, 2020 EyeExam, and the national and state efforts to fight back against plan abuses targeting doctors and patients.

“Through increased public awareness of optometry and advocacy focused squarely on going after the harmful payer abuses that restrict access to the essential care we provide, the AOA and state associations are making this a historic year of advancement for our practices and our profession,” Dr. Horn said. “By working together to implement the #2020EyeExam campaign, persuading more Americans than ever to see their family optometrist for a comprehensive eye exam, and advocating for tough, new pro-doctor laws, such as the Dental and Optometric Care Access Act (DOC Access Act), we’re going all out to put a nationwide spotlight on optometry throughout 2020.”

Elaborating on a cornerstone of the 2020EyeExam campaign, the employer pledge program now has nearly 40 participating employers that reach more than 350,000 employees. Dr. Horn challenged affiliates and volunteers to get the word out, enlisting more employers as the year progresses.

So, too, Dr. Horn announced the AOA will roll out resources to help support new, patient-centered connections with local care providers, grounded in the AOA’s updated diabetes guideline, and soon available through the AOA’s forthcoming website redesign. All these components culminate in the multi-channel, public relations campaign-#2020EyeExam-that encourages Americans to start caring for themselves by their eye exam and making it a part of their annual health care routine. This public encouragement is central to the AOA’s Save Your Vision Month campaign in March, where the AOA will announce new partnerships and drive additional engagement and media coverage.

“We are charging ahead and partnering with all of you to get this message out,” Dr. Horn said. “What do we ask of you? Join the conversation and the initiative; share the visuals on your social channels; get the word out in your communities; use the #2020EyeExam hashtag; and, join in getting your fellow doctors engaged in enlisting employers in the pledge. Because when we all work together, we will make an impact.”

Providing an update on the AOA’s advocacy priorities, Dr. Horn discussed concerning federal legislation to expand Medicare coverage for refraction and contact lens fittings. This underfunded, unworkable new vision benefit could harm doctors and patients, and the AOA’s Federal Relations Committee and staff have actively engaged legislators since the beginning. Although passed in the U.S. House, the bill is unlikely to pass the U.S. Senate in current form. Still, the AOA remains vigilant.

Additionally, Dr. Horn reminded volunteers to encourage their legislators’ support on AOA’s priority legislation, H.R. 3762, the DOC Access Act,  and H.R. 3975, the Contact Lens Prescription Verification Modernization Act,  while also preparing affiliates for a resurgence in veterans’ care challenges and doubling down on a zero-tolerance policy for abusive plan practices.

Visit the AOA’s Legislative Action Center or contact the AOA’s advocacy team for more information about how you can help ensure optometry is heard in Washington, D.C.

Additionally, the AOA’s State Government Relations Center (SGRC) provided affiliates a broad overview and updates from the fledgling 2020 legislative session, now with at least 33 states convened. This session could prove one of the busiest ever for affiliates nationwide with issues ranging from drivers licensing and children’s vision measures to scope expansion, the SGRC notes, yet affiliates are better prepared than years prior to see success in states’ legislatures.

In other news, the AOA also updated affiliates and volunteers on:

AOAExcel®’s group purchasing organization adding optical products, including contact lenses, frames and lens materials, to help members be more competitive.

The Presidents’ Council not only serves as a forum between the AOA and affiliates on priority issues affecting the profession or association but also an opportunity to provide leadership development and volunteer orientation. Among these opportunities, affiliate leaders and staff collaborated in best practices breakouts to share workable solutions or voice challenges in their respective states or associations, as well as several topical sessions useful for affiliate organization or leadership, including:

  • An Executive Directors summit.
  • Volunteer leadership orientation.
  • Advocacy primers in state legislative and third-party issues.
  • Association challenges.
  • Leader-to-leader meetings.

This leadership development continued with leadership consultant and inspirational speaker Pam Boyd. The owner of Dramatic Conclusions consulting firm, Boyd spoke to “optimal, drama-free” engagement among volunteers and associates by espousing effective business communication and management strategies.

“The opportunity to develop leadership skills, to network with other leaders in optometry, to provide input to AOA and to hear what’s going on elsewhere in the profession creates an atmosphere that’s very conducive to enhancing the effectiveness of our staff and volunteer leaders in attendance as they seek to advance the profession-one of our main missions,” says Dr. Wroten.

“I know I always leave encouraged and inspired by these great leaders in optometry, from all over the country, who are so passionately striving to make our profession all that it can be.”

Gambles Honored with Humanitarian Scholarship

Dr. James Gamble, founding member of the Columbia Eyes Consultants Optometry practice in Columbia, Missouri.


Dr. James Gamble was a founding member of the Columbia Eye Consultants Optometry practice in Columbia, Missouri and established an eye care clinic in Chichicastenango, Gatemala as a personal mission. His practice partners joined him in the project and have returned to the area for numerous visit since 2000 to provide eye care and spectacles to the local population in need.

In addition, Dr. Gamble and his practice have funded expenses for University of the Incarnate Word, Rosenberg School of Optometry students and faculty to be a part of this endeavor. Students and faculty have benefited from the humnitarian and philanthropic work that he and his wife, Anita, began, which is consistent with the mission of UIW. This award recognizes a fourth-year optometry student who embodies this humanitarian spirit.

The winner will be faculty nominated. The candidate will have demonstrated a holistic interest in helping those who may not have access to care and in addressing healthcare disparities. The recipient must have a minimum GPA of 3.0 and be in good institutional standing. Eligible students must be in their fourth professional year and nominated by a faculty member by November 1 of the award year. The nominees will be reviewed by the Scholarship and Awards Committee and the Director of Outreach Programs. The awardee will be announced before the beginning of the Spring semester.

MOA Coronavirus Statement

As we all try to navigate the rapidly changing COVID-19 pandemic, the MOA wants you to know that we are here to offer you resources and guidance.  None of us have ever experienced anything like this.  The AOA has sent communications to members and is working with the federal government and the CDC to ensure members have access to small business loans as well as access to telemedicine billing for Medicare patients They have created a website with resources specific to optometry.

Please visit There you will find current developments and practice tools for continued guidance.

The Missouri Dept of Health and Human Services also has a web page with the latest state information:

There you will find a link to the CDC situation summary page:

We all have difficult decisions to make as we determine how we go forward in offering patient care.  It is a personal decision and we must each do what is right for our own practices and families.  We urge you to use these resources.

Practices will need to also make some contingency business plans specific to your own situations. At this time, there have been no actions from the Missouri Dept of Health or the Governor for individual practices.  The MOA will monitor for any state or federal initiatives put in place to offset any financial impact this pandemic has on our practices.

For information regarding unemployment, PTO and other labor topics please refer to the Missouri Dept of Labor website for their FAQ and information regarding the pandemic:

As part of the health care team, if your situation permits, we should be at least available for emergency care and do our part to keep patients out of the emergency rooms where they are definitely placed at a higher risk.

Let’s all do our part to “flatten the curve” and keep washing those hands!

Suggestions for your practices:

  1. Consider postponing and rescheduling those patients age 60 years and older, patients with comorbidities, patients who are immunocompromised or closing your office to nonemergency visits.
  2. Screening conducted by telephone may be a way to mitigate the risk from office visits. Ideally, this would be done on the day of service.
  3. Consider staggering appointment times or spread out appointments to socially distance patients.
  4. Contemplate implementing virtual check-ins via text from your parking lot to reduce time in your waiting room.
  5. Consider taking the temperature of patients that have to be seen when they enter your office.
  6. Ask caregivers accompanying patients to their appointments to remain in their cars unless assistance is absolutely needed to reduce congregating in waiting rooms – implement social distancing procedures.
  7. Reduce patients moving from room to room and keep patients isolated from others as much as possible.
  8. Use universal precautions and follow disinfection recommendations from the CDC. This goes beyond basic personal and clinic hygiene. Re-evaluate your disinfecting procedures.
  9. Consider strategies to reduce person to person exposure at the slit lamp.
  10. Contemplate how you want to handle in office contact lens hygiene especially for new fits.
  11. Consider rotating doctors and staff seeing patients on different days (platooning) to reduce risk of multiple practitioners from being exposed simultaneously.
  12. Implement telemedicine and phone triage techniques for nonemergency eye conditions.

Legislative Conference Is a Wrap

Winter weather was a minor incidence at this year’s MOA Legislative Conference. There were some threats of unsafe driving conditions in the forecast, but providence prevailed and conditions improved just before the conference. Everyone was able to make it to the Sunday afternoon committee meetings. One of the important functions at the conference is volunteer committee members working to lay out a course of action for the Missouri Optometric Association board.

Our leadership had asked all fans of the Kansas City Chiefs to wear red on Sunday afternoon in support of their team in the AFC playoffs. A large screen projection system had been set-up to allow fans to monitor the game during our meetings. It was an exciting afternoon of football and important committee meetings to start off the conference.

On Monday, the legislative conference day began with continuing education presented by Dr. Raymond Brill, who presented information on Intense Pulsed Light in the Dry Eye World. Dr. Brill was followed by a presentation by Dana Reason, AOA Regional Advocacy Liaison on Keyperson Training.

After lunch, our guest speaker was Crystal Quade, the Missouri House Minority Floor Leader. Following her excellent talk we were presented with a legislative forecast by our MOA lobbyist, Jay Hahn, after which the MOA members completed our annual trek to the Missouri Capitol to visit with our legislators.

The legislative day was highlighted by a legislative reception at the Millbottom Event Center Monday evening where MOA members had an opportunity to visit with their legislator and talk about important issues.