This article is more than 5 years old. Information may no longer be current.
Ophthalmology may be well-positioned to weather next economic downturn
Click Here to Manage Email Alerts
A quote credited to Louis Pasteur, “Fortune favors the prepared mind,” is one of my favorites. “Once you stop learning, you start dying” by Albert Einstein is another. Einstein was a unique, ever inquisitive and brilliant Nobel Prize-winning mind, broad in application and always open to change and innovation. You can look up his most famous quotes on the internet, all of which are worth some time contemplating.
The accompanying cover story was developed after a keynote lecture I gave at the 2019 Cataract Surgery: Telling It Like It Is meeting in Orlando. My good friend Bobby Osher, MD, the course director, asked me to give a keynote lecture titled “Do You See What I See.” As the meeting title demands, he wanted me to be direct and not sugarcoat my thoughts. Relying heavily on years of shared ideas with another good friend, John Pinto, with some trepidation I put together a 30-minute lecture. The trepidation stems from the fact that all the things I see facing our great nation and beloved specialty of ophthalmology are not positive.
I ask that as you read the accompanying cover story: Please do not kill the messengers, as both John Pinto and I have dedicated our careers to helping both our colleagues and the industry that supports us to not only survive but thrive. Some of my thinking is also heavily influenced by Harry Dent Jr., perhaps our era’s top expert on economic cycles and the impact of demographics on those cycles. Harry is my No. 1 economic guru, and I follow his teaching carefully. You can also look him up on the web and order one or more of his books. He is not always right — nor am I, nor is John — but we all try to be fact based and look to the future with a realistic but optimistic view.
I believe ophthalmology will do just fine, thank you, and that compared with many of our colleagues in other medical specialties, we are well-positioned to prosper in the decades ahead. Still, there is no shortage of challenges facing us in the short term. If you believe in cycle theory, we are about 90 years into the so-called Kondratieff Wave, an economic supercycle that runs about 90 years and repeats itself. The bottom of the last 90-year Kondratieff Wave economic supercycle was 1929-1933. Add 90 years and we get 2019-2023. The Kondratieff Wave predicts that economic excess and debt will be liquidated through a deflationary recession/depression, like the one experienced in the United States between 1929-1933. The alternative is an inflationary recession/depression as exemplified by the Venezuela of today or Germany after World War I.
Harry Dent believes we will get another deflationary recession/depression between 2019-2023. If it happens before the next election, Donald Trump is almost certainly out as president of the U.S. If it happens after the next election, President Trump may well get re-elected only to be credited with the massive correction that follows, much like his fellow conservative Republican President Herbert Hoover, who had the misfortune of being president of the United States at the onset of the last Great Depression.
While an analysis of cause and effect for the Great Depression of 1929-1933 is complex and debatable, some important factors were irrational exuberance in the stock and real estate market during the 1920s followed by rising short-term interest rates and passage of the protectionist Smoot-Hawley Tariff Act. Even the casual observer can see some similarities with our situation today, with a longer than average stock and real estate bull market, a yield curve that just inverted as the Fed increases short-term interest rates and a new wave of tariffs and protectionism as we put “America first.”
The prepared mind of 1929 avoided the stock market crash, was debt-free and was gainfully employed in a recession-proof profession or trade. I believe ophthalmology will nicely carry today’s properly positioned individual who is not overly leveraged at home or at work through a few tough years to the next recovery. Quality vision is precious and valued by everyone. Public demand for what we provide as ophthalmologists is rising at least twice as fast as the general economy. And our numbers are at best flat. Our future is bright, but both John and I believe each of our personal journeys over the next decade can be made a lot easier by a careful look at the external and internal environment within which we practice followed by formulation of an appropriate personal and practice business plan.
Disclosure: Lindstrom reports he practices ophthalmology, is an equity owner and board member of Unifeye Vision Partners, and is an equity owner, board member, medical advisory board member or consultant to many ophthalmology companies both large and small.