Perhaps most importantly, looking to the future, the AAO is aware of the coming pressures created by the demographics of the baby boomers and other factors that will alter the health care landscape. With concerns about a physician workforce shortfall relative to market demand in 2020,12 many physician organizations have sought to increase the numbers of physicians over the next 20 years to help meet anticipated market needs. Given the long lag time to train new providers to become available to provide care as well as the longer-term concern of potential declining population needs after the baby boomer generation, it is not clear that a strategy to increase physician supply is necessarily the only appropriate course. Instead, within ophthalmology, concerns about a surplus of eye care providers in the recent past13 combined with continued enhancements in care for the most common conditions such as cataract and retinal diseases suggest an alternative approach to ensure greater access for more people in the future. Through improved efficiencies, enhanced productivity, and new work and business models of seeing patients, we can provide new avenues to more rapidly and effectively address the access needs of the American public as they grow in the short and longer term. Indeed, in a 2005 survey of its members, the AAO learned that 52% of members would like to see, on average, 33% more patients, whereas 48% and 43% of members felt that their area had the right amount or too many ophthalmologists, respectively. Only 4% of members felt there were too few ophthalmologists.