Sunday, June 20, 2021
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James R. Auvil, OD, MBA, FAAO, CPC

On January 16th, I received a message from Dr. Michael Pattison entitled “DUES”. In the last paragraph of the message, he mentions, “…I no longer get the Retention Bonus, the Continuation Pay, or that $100 Optometry Pay we all complain about…For those of you who get that money, remember to thank the AOA for it.”

Not so fast. Retention bonuses and “continuation pay” (whatever that is) have nothing to do with the AOA. Those are service-specific pays to address personnel shortages. The AOA apparently supported the $100 per month professional pay when it was placed into law in 37 USC 302, section 302a, which became effective on 1 October, 1971. It remains unchanged after 40 years and 4 months and counting, despite a real inflation rate of 458.6%, increases in federal optometry responsibilities, and increases in our scope of practice.

$100 today has the same purchasing power as $17.90 had in 1971.  Can you imagine how popular this special pay would have been had the AOA successfully supported legislation to start professional pay at  $17.90 per month back then?  Well, that's what it's become. Unfortunately, this amount won’t send my kid to college, or pay for a still-never-taken family vacation. Adjusted for inflation alone (linked to the Consumer Price Index, courtesy of the Bureau of Labor Statistics here:, the amount should be about $560 per month. That’s a car payment and then some. That would cover room and board for my kid who is in college.

Before anyone starts a campaign to increase monthly special pay to $560, consider scope of practice changes and increases in responsibility. We’re not just spinning dials. We’re running small business units within our Services, and optometrists in some of the federal Services get absolutely NO specialty/professional pay. $560 is about half of what the monthly professional pay should be - a more appropriate amount would be around $1300 per month.  I oversee a five-clinic operation, generating over $3.7M in CPT "revenue" at a cost to the American taxpayer of about $1.4M - my clinics operate at a 325% profit margin, with over 40,000 patient encounters and 70,000 procedures this past fiscal year.  Is this what federal ODs did back in 1971? I don't think so. They "just" performed eye exams, they didn't run federal business units. We've been doing more with less, and FOR less, for the past forty years. I think it's time for a major adjustment.

Now consider what we haven't received: the money lost over decades of being underpaid, as the purchasing power dwindled. For an officer who served through 2011, consider the following:

40-year career: $48,000 in ProPay; should have been $114,498; loss of $66,498

30-year career: $36,000 in ProPay; should have been $107,619; loss of $71,619

25-year career: $30,000 in ProPay; should have been $97,988; loss of $67,988

20-year career: $24,000 in ProPay; should have been $85,004; loss of $61,004

15-year career: $18,000 in ProPay; should have been $68,573; loss of $50,573

10-year career: $12,000 in ProPay; should have been $49,267; loss of $37,267

5-year career: $6000 in ProPay; should have been $26,488; loss of $20,488

3-year career: $3600 in ProPay; should have been $16,198; loss of $12,598

These amounts are only corrected for inflation. The actual value of the "loss" could be much, much more if that money were paid to you and invested, or used to pay off existing debt. The benefit to you could be significantly more in terms of interest earned if invested, or interest avoided if used to pay off debt.

Before you pat the AOA on the back, consider how hard (or how not-hard) the AOA has worked in your interests over the past four decades, now heading into a fifth decade, since the professional pay legislation became effective. The lack of action to support federally-employed optometrists should come as no surprise when leaders consider a loss of over $60,000 over a career as an AOA value. I think it's shameful.

It would be inappropriate to point out a problem without suggesting a solution. Changing US Code to correct this professional pay problem will take a long time, but it must be done. In the short term, if AFOS wants to claim optometry professional pay as an AOA "win" perhaps the AOA should roll back dues for federal service optometrists to the 1971 rate, and keep it at that rate until the professional pay problem is resolved. That sounds like a step in the right direction, and something AFOS should seek this June at the AOA annual meeting.

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