7+ Year Member
Apr 2, 2013
Attending Physician

There's been surprisingly little discussion on these forums about the increasing corporatization of medicine. While there's plenty of discussion about appropriate midlevel scope of practice, I believe that private equity involvement in medicine is a potentially even bigger threat to medicine as a whole, and the worst part of it is, there's not enough discussion on this topic, allowing private equity groups to slowly buy up groups and increase their dominance in the field. A significant majority of certain fields such as emergency medicine, anesthesiology, and pathology are already dominated by these groups seeking to make a profit off of patients, and they are additionally attempting to increase their market share of other fields such as radiology and dermatology. At this rate, if this issue isn't dealt with soon, the entire medical field will be beholden to private equity whose inherent reason for existing is to make a profit.

Profit should never be allowed to be a conflict of interest when making medical decisions, and there's an inherent conflict of interest when private equities own medical practices and an underlying profit motive is present, no matter what pretty words they use to try to obfusticate that fact. Historically, there has been legislation enacted to attempt to prevent the profit conflict of medicine by mandating that medical practices need to be physician-owned, but private equity has been skirting these laws by setting up shell companies and in effect using a loophole to violate the spirit of the law.

This issue needs to be addressed now -- the horse is already out of the barn for some specialties unfortunately, but in other areas, there is enough time that if we can raise awareness and discussion at the national level, we can hopefully halt or even reverse this insidious trend and threat to the field of medicine. It is a blasphemy of the Hippocratic oath - one cannot be fundamentally beholden to both best medical care and the profit motive without one influencing the other.


holding a barbell.
7+ Year Member
Jul 11, 2013
In my gaff
I think it's inevitable. They are going to run every practice into the ground until there's no more money to be made.


SDN Bronze Donor
Bronze Donor
7+ Year Member
Apr 29, 2013
Fellow [Any Field]
HCA Healthcare is the largest sponsor of graduate medical education programs in the U.S. We train nearly 4,000 residents and fellows across 56 teaching hospitals in 14 states, primarily in the Southeast, across the Sunbelt and in the Inner Mountain West regions, where there is a shortage of residency positions. Over the next five years, we expect to accommodate as many as 7,000 residents, with a positive impact on patient care in our hospitals.
The 10 top programs this year are:

Program# Residents
Internal Medicine1,380
Family Medicine463
Emergency Medicine298

What is the number one specialty for HCA residency programs?
Who costs more money, hospitalists or internal medicine residents?

During the Great Recession, when many hospitals across the country were nearly brought to their knees by growing numbers of uninsured patients, one hospital system not only survived — it thrived.
In fact, profits at the health care industry giant HCA, which controls 163 hospitals from New Hampshire to California, have soared, far outpacing those of most of its competitors.
The big winners have been three private equity firms — including Bain Capital, co-founded by Mitt Romney, the Republican presidential candidate — that bought HCA in late 2006.
HCA’s robust profit growth has raised the value of the firms’ holdings to nearly three and a half times their initial investment in the $33 billion deal.


10+ Year Member
Oct 28, 2007
Dentistry (like pharmacy) is farther down this road than medicine.
The corporate dental office/clinic is now as common as the private practice office/clinic. These days the most most common place to start your career, as a young dentist, is in corporate office/clinic. Sadly, it is now the MBA's making the calls not healthcare providers. As a result, over treatment of the well insured has become a problem. Likewise, the disinfranchized and non-insured are totally ignored by the corporate operations. (One more way the "have-nots" are left out of the American Dream.)
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