At THE BRINK of the 21st century, ophthalmology is faced with numerous challenges... and opportunities. These come clothed in a new language, more the lingo of the business world than the profession (eg, managed care, cost-effectiveness, outcomes, throughputs, downsizing, capitation, and marketing). As we incorporate the business vocabulary into our profession, we also seem to incorporate other attributes of the commercial world by actively managing care for the bottom line, the shareholders, earnings-to-profits ratios, and marketshare. In this milieu, spending a half million dollars on a revenue-enhancing technology (eg, excimer laser) is easily justified while requests for paltry sums for physician or student education are deferred.
The language of the profession would not matter in an ideal world, as patients would always have access to quality care and would participate responsibly in their care. This world would recognize the ophthalmologist as a uniquely trained professional who offers all levels of