111. Does Private Equity Belong in Medicine?

What’s the impact of private equity’s increasingly large footprint in medicine? The results so far have not been promising.

We dissect: what is private equity, the recent bankruptcy of the largest emergency medicine staffer in the US and how that impacts clinicians, can corporations practice medicine, the American Academy of Emergency Medicine has jumped into the fray, does profit-driven medicine ever serve patient care, HCA has been accused of naughty deeds, performance metrics versus the one metric that really matters, the No Surprises Act, and physician unions.

Guest Bio: Leon Adelman, MD, MBA, FACEP, FAAEM is an emergency physician and co-founder of Ivy Clinicians, a software company that simplifies the emergency medicine job search through transparency. Dr. Adelman is the author and publisher of the Emergency Medicine Workforce Newsletter, which explores the business of emergency medicine. As medical director at Tennova Healthcare Clarksville and Johnston Health UNC (large rural EDs in Tennessee and North Carolina), Leon led emergency department teams to exceptional patient-centered outcomes. Leon is a graduate of Brown University, the University of North Carolina School of Medicine, the Harvard-Affiliated Emergency Medicine Residency at Beth Israel Deaconess Medical Center, and the University of Tennessee Haslam College of Business. Leon is married to an emergency nurse and has two adorable dogs.

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We Discuss:

• What does 'venture capital/private equity' in medicine really mean?
• The largest emergency medicine staffer in the US, Envision, recently went bankrupt.
• What happens with all of those clinicians and hospitals when the staffing company implodes?
• A corporation cannot practice medicine in most states in the US (but can in some!).
• The American Academy of Emergency Medicine is suing Envision and their corporate entity for the illegal corporate practice of medicine
• Is there a functional difference between the old-school CMG (contract management groups) and modern-day private equity-owning medical groups?
• Does profit-driven medicine ever serve patient care?
• HCA has been accused of funneling patients into end-of-life care to improve hospital mortality metrics.
• Has private equity made universal healthcare impossible in the US?
• The group you want to work for sees physicians as the business rather than an expense to minimize
• Quality of shift is a metric you rarely see on your monthly performance stats, but it should be at the top of the list
• Would you ever wash your rental car? The downstream of not having ownership in a group
• The No Surprises Act was set up to protect patients. It’s kind of a mess.
• Physician unions. Can doctors go on strike?
• Leon’s guess outlook for the emergency medicine job market in the coming years