The cover focus of this month's issue of Cataract & Refractive Surgery Today addresses a concept fundamental to each ophthalmic organization's present and future success. For surgical practices of any size to fulfill their purpose, those responsible for the business model must be able to correlate the caregiving goals of the physicians with a responsible financial plan. Administrators, therefore, have a major duty in monitoring a practice's business integrity both on a daily basis and for the long term.

We interviewed administrators from several practices across the country to learn how they successfully conjoin patient care with business acumen. The featured practices vary in size from a statewide presence to a single clinic with a subspecialty/boutique focus, and each has approached the business side of service provision differently, yet effectively. Of course, time and space could never allow us to highlight every noteworthy practice in our profession, but we have strived to include some from which others might learn a trick or two.

One notable exclusion from our group is a physician practice management corporation (PPMC) practice. I can recall completing my fellowship with but one item in my employment contract: my right of first refusal if the practice I joined decided to go the route of a PPMC. This business model may have made sense from an investment standpoint in the 1980s, but certainly not in 1995. This practice model, unfortunately, still exists. I recently returned from Australia, where I trembled to learn that a PPMC phenomenon is just beginning on that continent. Our Australian colleagues are being tempted with the same prescription that American PPMCs offered: the lure of multiples on their initial equity investment, losing half their vacation time yet working twice as hard, and being promised that, once the corporate venture goes public, they will be on easy street.

I am hopeful that this edition of CRSToday will allow our readers to assess their own business plans and perhaps take something away from the ideas elucidated by the authors herein. After all, strengthening our practices on the business side will only improve our offerings on the service side. By better understanding our business approach to practice, we can provide more enduring care and committment to our communities.