The Role of Board Certification as a Cue to Competence of Eye Care Providers: An Empirical Analysis

Abstract

Authors have long known of the need for “cues” to assess the competence and training of providers of credence services.  In the case of health care providers such as eye care professionals, one such cue is whether the eye care professional is “board certified.” This study of 500 consumers who had had an eye exam either from an optometrist or an ophthalmologist examines four questions: what factors are important to a consumer seeking an eye-care provider, what is communicated by an eye-care provider’s claim of being board certified, whether there are differences in perception between board certification as applied to an optometrist and an ophthalmologist, and whether there are differences in the perceptions of optometrists who are board certified compared to those who are not board certified. The results show that board certification is an important cue for consumers in assessing the competence and expertise of optometrists and that board certification can be used to distinguish between an optometrist and an ophthalmologist. The results also show that optometrists who are board certified as seen as better trained and more competent than optometrists who are not board certified. The results also raise questions about at the effectiveness of board certification as a cue for competence and expertise since most consumers believe optometrists are board certified when, in fact, board certification is voluntary and a very small percentage of optometrists licensed to practice in any state are actually board certified by either of the major certifying optometric organizations. Policy implications are also discussed, including the need for uniform standards for certification at the Federal and State level and the need for rigorous certification practices by third-party certifying organizations, including additional coursework and periodic assessment of optometrists’ performance to accurately reflect the enhanced quality and competence possessed by optometrists who are board certified.