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Cover Focus | Oct 2017

The Good, The Bad, and The Unknown

A discussion on private equity and corporate ophthalmology.

A few months ago, I was shopping for a gift for my nephew’s eighth birthday, and I called my sister-in-law for a few ideas. “Anything Under Armour,” she told me, “and the brighter the better.” Apparently today, at least in classrooms across the United States, this clothing brand is the latest trend, and school-aged boys often don the gear from head to toe in attempts to outdo one another.

I immediately found myself reminiscing about some of the popular trends of my youth—Chuck Taylor sneakers, snap bracelets, the French cuff, tie-dye, and flannel shirts. I remembered how important it was to wear the latest styles, most likely so that I could impress my classmates. Of course I did not realize it then, but many of the trends I experienced in childhood were actually borrowed from previous decades. Likewise, some of today’s trends have simply resurfaced from the yesteryears. (For instance, I recently found myself buying a pair of Chuck Taylors, although instead of some loud color that I owned as a teenager, I chose the more modest black.)

Trends aren’t restricted to fashion. Food, music, movies, finance, business: You name the industry, and you can be sure a current trend is brewing. The practice of medicine is no different. Right now in ophthalmology, investment from private equity (PE) is the latest trend in the push for consolidation of medical practices.

But even this is not an original trend; in the 1990s, some ophthalmology practices across the United States chose to partner with physician practice management companies (PPMCs) in the hopes of yielding higher returns. In many instances, the experience was not positive and the partnership was short-lived, with the PPMCs going into receivership and the banks taking ownership of many practices. Eventually, in many cases, the banks sold the practices back to the original owners—the individual doctors—and PE in ophthalmology was dead. Until now.

PE is once again interested in ophthalmology. Although more prevalent in the United States, the trend will migrate to Europe within the next 4 to 7 years, some experts say. In the meantime, a parallel trend is already afoot in Europe: corporate ophthalmology, a category that encompasses organizations such as Optegra Eye Hospitals, EuroEyes, and Aire Eye Hospitals.

What lessons learned in the 1990s can be applied to today’s trends in PE and corporate ophthalmology? What are the advantages and disadvantages of these systems of health care? What’s in it for you, the ophthalmologist? If you are interested in finding out, this cover focus is for you.

—Laura Straub, Editor-in-Chief