The Disenfranchised Physician—"Disrupting Eye Care"

By Bob Sweeney

July 30, 2019

We continue our series investigating how changes in health care and its technological infrastructure are disaffecting practicing physicians.   One way to illustrate these effects is to look at specific contexts and applications.  Today’s case study is the contact lens industry.

A recent article in the New York Times describes how Hubble, a new start-up company, has gone about disrupting this industry and the practice lives of ophthalmologists and optometrists.    Here’s a link:

The company, founded in 2016, saw an opportunity to make a profit and do social good by breaking up the sweetheart alliance between brand name lens production companies and prescribing professionals.  Hubble claims that the old boys network in lens prescribing locks competitors out.  So, Hubble and other low cost competitors use an obscure but apparently legal method called “passive verification” to get around prescriptions that list lens choices by name.  Consumers appear to realize large savings through this change in traditional methods.

The downside of this trend is that the quality of these substituted lenses is subpar, and the patient user ends up getting little or no eye care or examination by specialists.  So, the quality of care is compromised and one more chink is created in the patient-provider relationship.  Naturally, the specialists lose income as well.  Since quality of care is an intangible that often requires time to be manifested, short-term tangible financial incentives prevail in consumer choice-making.  If we were talking about hair spray or razor blades, the downside would be dissatisfied customers.  With a product delivering a health consequence, the downside could be much more consequential.

For the optometrist or ophthalmologist, the net result of this transactional model is a diminished opportunity to direct their patients to the most appropriate corrective lens, and a wholesale devaluation of their clinical expertise.  We’ll return to more examples of this disenfranchisement in future blogs.  Stay tuned!


Robert E. “Bob” Sweeney, DA, MS

Principal & Managing Director