HOW TO GET RICH OFF PERESTROIKA A surgeon named Svyatoslav Fyodorov has built an eye-care empire based on his pioneering operation for myopia. He could be a model of the new Soviet manager.
By Pierre Pean

(FORTUNE Magazine) – PERESTROIKA, Mikhail Gorbachev's economic restructuring, has been full of surprises. The most startling may be the rise of Svyatoslav Fyodorov, a medical entrepreneur who has all the trappings of Gorbachev's first millionaire. His institute for ophthalmic microsurgery has become a $75- million-a-year business that is growing 30% annually. From a Moscow office crammed with electronic gear, he presides over nearly 5,000 employees in nine treatment centers across the Soviet Union and two factories that turn out glasses and surgical instruments. An eye surgeon, Fyodorov, 61, pioneered a revolutionary treatment for myopia called radial keratotomy. It involves correcting the curvature of the cornea surgically to bring distant objects into focus without glasses. A few U.S. surgeons have begun performing the procedure. The American Academy of Ophthalmology, while stopping short of endorsing the method, concedes that it can help some patients. But the U.S. group also warns that the surgery sometimes results in too much correction, leaving patients unable to see up close. That hasn't deterred Fyodorov's patients. His clinics operate on 220,000 people annually, 5,500 of them foreigners. He hopes to double capacity by 1992. Fyodorov is not wealthy the way a Westerner of his accomplishments would be. He earns a salary of about $35,000 a year. That's only a little more than five times what a nurse is paid, though as he points out with a laugh, it's ''more than Gorbachev makes.'' The perks in both cases are terrific. Fyodorov lives like a latter-day czarist nobleman. He has access to a telephone-equipped car, airplanes, roomy apartments, and country dachas. Much of that is standard for members of the Soviet elite, but Fyodorov adds a touch or two of his own. Three mornings a week he goes riding on one of his 53 horses. An avid hunter, he recently bagged two wild boars and a moose. Wielding his enterprise's checkbook, he can deal like a Soviet Donald Trump. Consider one week last winter. He bought two yachts for more than $200,000 each so that he and his employees could use them in their free time. He paid $52 million for a small passenger ship that will undergo a $12 million refurbishing and become a floating hospital, cruising the Persian Gulf to help relieve the sheikhs of their petrodollars. Earlier he acquired a giant cargo plane now being converted into a flying hospital. He is negotiating for an executive aircraft to ferry his top managers around. Is this entrepreneur the living embodiment of perestroika? One thing is sure: He couldn't do any of it without official backing. Which suggests that Soviet authorities, from Gorbachev down, would be more than happy to create a new breed of manager as able as Fyodorov.

His spacious, paneled office on the third floor of a hospital 11 miles from the Kremlin would not embarrass a Rockefeller or a Ford -- though a capitalist would be unlikely to display photographs of Lenin, Gorbachev, and Fidel Castro. Fyodorov keeps up with medical journals and operates three times a week. But much of his time is spent managing. By throwing a switch on a console next to his desk, he can be connected by satellite to his principal subordinates in other parts of the country. Their faces appear on television screens mounted on the wall. He also does accounts, invests rubles by the bushel, signs documents, issues orders, and answers his beeper. How does he get it all done? ''I get between four and a half and five hours of sleep a night,'' he says. Just elected to the Soviet legislature as a deputy from Moscow, he plans to fit in his new duties by sleeping less. Creating such a enterprise anywhere requires unusual dedication. For Fyodorov it has become a crusade. ''I want to destroy the Stalinist bureaucratic system,'' he says. ''I hate it because it has ruined everything -- culture, nature, generosity.'' Perhaps he is saying aloud what Gorbachev secretly thinks. Fyodorov is not the only Soviet citizen seeking fundamental change these days, but for him the quest is also personal. He's out for revenge. Born in 1927, he grew up in the Ukraine devouring the adventure stories of Jack London and Alexander Dumas. When he was 11, his idyllic world was shattered. His father, a cavalry general, disappeared in one of Stalin's purges of the army. Fyodorov was convinced his father had been killed. In 1950, while finishing medical studies in Rostov, he learned that his father had been in a prison camp in Siberia since the purge. Fyodorov says he will never forget their reunion five years later: ''His face was sad. When a man has not laughed for a long time, he can only imitate a smile.'' GORBACHEV'S assumption of power in 1985 was a turning point for Fyodorov. He had been performing his surgical technique since the 1970s, but he felt neglected by high officials. He wrote a letter complaining that though he was three times as productive as his colleagues, the ministry of health would not give him money. Nicolai Tikhonov, who had become premier of the council of ministers, called him in. ''You are right,'' Tikhonov said. ''It's a scandal.'' After that things moved quickly. The state enterprise directed by Fyodorov got $300 for each successful operation and was allowed to keep the hard currency from foreign patients. That enabled Fyodorov to buy the latest equipment from the West. His aim now is to attract more foreign patients to Moscow and to open clinics outside the Soviet Union. To build his foreign business, he signed an agreement last September with Francis Bouygues, owner of the largest construction company in France, to build a 250-bed hotel and clinic on the edge of Moscow. Fyodorov hopes to | treat 20,000 foreigners a year by 1992. At their first meeting, Fyodorov and Bouygues had instant rapport. Says Jean-Paul Combot, a Bouygues executive who is heading construction of the project: ''Fyodorov is an extraordinary man, a true and great boss in the Western sense. He works like us. At his headquarters everybody waits on his orders.'' Fyodorov is negotiating joint ventures in Bulgaria, Italy, Cyprus, and Malaysia, and is thinking about projects in a dozen other countries, including the People's Republic of China. Why not in France, since he has such a happy relationship with Bouygues? ''It's too soon,'' he says. ''The ophthalmologists there are too strong. They will hold out for another five to seven years. They need a good kick in the tail to get them to stop resisting the idea.'' Their resistance is understandable since Fyodorov practices surgery the way Ford turns out cars -- on an assembly line. Eight beds are arranged around a central axis like spokes in a wheel. A surgeon stands at the head of each bed, on which only the eye of the patient is visible. After each doctor finishes his portion of the task, the wheel makes one-eighth of a turn. The next surgeon verifies that his predecessor performed properly and then does his own part of the operation. The eight doctors talk to each other through tiny microphones and headsets. Soft music plays in the background. The doctors and nurses often smile, and it isn't just because of the music. They make far more money than colleagues in other branches of medicine. Pay varies with the number of operations performed, but a surgeon's salary can reach $19,000 a year. Productivity and success are key words in Fyodorov's clinics. Nurses earn $6,660 a year, three times as much as their counterparts at the best Moscow hospitals. There are plenty of applicants, and those chosen are put through a rigorous training program. Fyodorov augments the salaries, small by Western standards, with generous perks that will include housing as well as yachts. ''That's real socialism,'' he says. He welcomes any kind of publicity: ''Scandal, it's wonderful.'' A book about him has been published in the Soviet Union, and at the end of February, 109 journalists from around the world assembled to interview him, a sure sign that he has made himself and his enterprise an example of Soviet renewal. A fervent believer in perestroika, Fyodorov thinks failure ''will be the end of the nation.'' He adds: ''We can't keep trying to give lessons to the whole planet. Quite the opposite.'' His major fear is that Gorbachev will be captured by the old bureaucracy or that he will pursue personal glory rather than reform. FYODOROV'S inexhaustible energy -- and his defiance of traditional Soviet methods -- spills over into agriculture. He operates two farms, totaling 6,000 acres, with a herd of 750 dairy cows. Why? ''To prove that when people are interested in their work they can do better than the collective farms,'' he says. After giving some of the food to the state, he sends the rest to the kitchens in his clinics.

The cavalryman's son discovered horses during a visit to the U.S. A doctor in Detroit and his daughter, a superb horsewoman, introduced him to riding, and he acquired a 3-year-old filly. He now keeps all of his horses at a stud farm in Dubna, some 80 miles from Moscow. The spread is run by Tito Pontecorvo, son of an Italian atomic physicist who vanished in 1950 and reappeared five years later in Moscow preaching general disarmament. Fyodorov and Pontecorvo are in the process of getting rights to raise Akhal Teke horses, a Russian breed that they want to sell worldwide. Fyodorov has opened a riding club with 150 horses on 75 acres some 60 miles from Moscow. With a straight face, he says it's productive for his employees to ride horseback occasionally. For himself, every Monday, Wednesday, and Friday he pulls on his boots, slips into a denim jacket, and gallops away. It will be hard for even Gorbachev to catch him.