How a profession was hijacked by amateurs and lived to tell the tale

The revolution in laser eye surgery happened in 1992. Before that time, if you wanted to have your eyes lasered you would have to go to a consultant ophthalmologist and pay at least £1,500 (per eye) to have the procedure. Then an entrepreneur with no medical background came into the market, bought a laser, hired a few maverick doctors and started offering the same procedure for £395.

The establishment was in uproar. There were accusations of unethical practice, employment of charlatans who shouldn’t be performing such surgery and a demand to stop putting the public into danger. But soon other businessmen jumped in and the costs for laser surgery plummeted. Doctors without any specialism were soon lining up to perform the procedure, which was still in its infancy and delivering results that were poor compared to today’s surgery. The money they brought home was far better than they were making elsewhere, and being in a new industry they were soon able to present at global conferences and produce many research papers.

Meanwhile the consultants saw their licence to print money taken away by these upstarts. Of course, some people still chose to trust their eyes to those with the best qualifications. But the vast majority were driven by price and were prepared to believe that the process was fairly mechanical in any case.

So the surgeons who had commanded the highest salaries were left with very little business, and before too long started to approach the entrepreneurs, who by now owned chains of clinics around the UK and were even planning global expansion. The surgeons offered their services to these clinics, and some were taken on by their hitherto arch-enemies at low rates that they would have laughed at previously.

And so, over time a new equilibrium was established. The commercial clinics were able to upskill their surgical teams as the quality of doctors looking for work rapidly increased, while many of the ones with whom the clinics had started the revolution were quietly removed. At the same time some of the early doctors had taken the time to train in the new discipline and gradually became respected by their peers.

As a result you had two camps: one where surgeons performed high volumes for relatively low money per case in businesses that marketed heavily around price; and another where surgeons positioned themselves as experts and commanded an even higher fee than before all this change. But by communicating that knowledge and experience to their customers they filled their appointment books and were happy to be once again receiving the recognition and respect they deserved.

And that’s pretty much where that industry is today. Neither model has disappeared, contrary to the others’ predictions of doom. Both make a good living as there is a demand for both low cost operations and a highly personalised service. In the end, the fluctuating changes in supply and demand of both doctors and patients created a form of self-regulation that has served the industry better than most predicted along a very turbulent road.

If this sounds a million miles from the world of travel, one only needs to read the many discussions about the future of the travel agent or travel writer to see that these challenges and conflicts exist in almost every industry. All I suspect will find a level at which they survive and in the case of some, thrive by exploiting the new rules of the industry; rules that are still being written through these valuable debates.

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3 Responses to “How a profession was hijacked by amateurs and lived to tell the tale”

  1. Great analogy. It’s very interesting, isn’t it? I don’t think the whole story has been told though – as you imply, the levelling out process is still happening.

    February 7, 2010 at 9:24 pm Reply
  2. Thanks Andy. Yup, I think the state of the travel industry in 10 yrs time is hard to predict at this point, but if it’s like any other then those who are good at what they do now will still be doing successfully in the future.

    February 7, 2010 at 10:48 pm Reply
  3. It’s more or less what it’s happening with Photography now. Experts are offering courses and showing amateurs how to make better photographs.

    February 15, 2010 at 9:08 am Reply

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