The Slippery Slope: Corporate Optometry, Oversupply and Falling Compensation - Dr. Keyur Patel

Following our eye-opening episode on Australian optometrists unionizing in response to growing corporate pressure, The 20/20 Podcast turns to the United Kingdom—and the warning signs are just as important. Dr. Harbir Sian sits down with Dr. Keyur Patel, an experienced UK optometrist who has worked across corporate, hospital and independent practice settings and also trained in the United States. Together, they examine how decades of undervaluing clinical services, increasing corporatization and a growing dependence on retail revenue have reshaped optometry in the UK. Keyur also shares his own experience of being dismissed from a refractive surgery company despite no concerns about his clinical ability—because he was not converting enough patients to laser surgery. The conversation then moves to one of the most consequential issues facing the profession: workforce oversupply. With more optometry schools opening and more graduates entering already saturated markets, compensation can be driven lower while individual optometrists lose negotiating power. Keyur and Harbir discuss reports of locum positions paying as little as £25 per hour and the uncomfortable economics behind it: when there are more optometrists competing for fewer desirable jobs, employers gain leverage, salaries decline, and clinicians may feel increasingly pressured to accept working conditions or business models they otherwise would not. Combined with low reimbursement for eye examinations and diagnostic services, that environment can push practices further toward KPIs, spectacle sales and other commercial metrics simply to remain profitable. For optometrists in Canada and the United States, the UK and Australia may offer a glimpse of what can happen when these changes are allowed to compound over decades. More schools, more graduates, lower professional compensation, weaker negotiating power, increasing corporate influence and the gradual erosion of clinical autonomy do not happen overnight—but they can fundamentally change a profession. At the same time, Keyur offers a powerful counterexample: his independent practice walked away from the low-fee NHS sight-test model and built a practice where patients willingly pay more because they value the quality of care, relationships and experience they receive. The message is clear: if optometrists do not actively protect the value of their clinical services and the independence of the profession, others will define that value for them. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/