Private Equity and Healthcare

by | 12/04/21 | 1 comment

Match Made in Heaven or Destructive Force Against Patient-centered Care?

Well, this changes everything…

I just found out 2 weeks ago that my boss and founder of my employing company has sold the practice to a Private Equity-owned dermatology organization. Our CEO will no longer be a double-board-certified physician that is passionate about patient care and positive outcomes, but a private equity manager that specializes in buying up smaller businesses, turning them into cash cows, and selling them off for more profit.

I know this is inevitable when you work for a successful small practice, as they are prime prey for hungry investors, but my boss (the CEO and founder of my company) assured me at our interview 1.5 years ago that he would remain the primary owner of the company until his retirement in about 5 years.

He then proceeded to tell me about his succession plan that included keeping the practice in the family. I appreciated the reassurance that the practice would maintain its small-practice feel.

Which is why today it is so difficult to realize that my passionate and caring boss has sold to a gigantic PE firm whose portfolio includes eShipping, HVAC supplies, truck and trailer supplies, and other commodities. Everyone knows what happens to medical practices when they are owned by suit-and-tie executives and administrators. Just look at the hospitals.

Healthcare stops being patient-centered, and it becomes money-centered. Employees become a cog in a money-making machine. Healthcare providers get burnt-out. The Mohs physician becomes a replaceable commodity.

The literal purpose of PE is to buy a company, grow profits exponentially (at least on paper), then sell for more profit to the next PE. And somewhere caught in the middle of all of this are our patients.

They are our brothers, sisters, our parents, our nieces and nephews who also go to see dermatologists for various reasons. I do not want my patients nor my family to become just a number.

I have had so many of my new patients come from PE-owned dermatology practices that tell me exactly this. That they came to me because at their last dermatologist, they felt like “just a number.” I have had patients look at me in grateful amazement because I “only did one biopsy.” This patient with no skin cancer risk factors will tell me that when they came from So-and-so practice (which have over 80 locations in over 13 states), they will leave with AT LEAST 5 biopsies done. I cannot remember the last time I have done that many biopsies on one low-risk patient in one visit. Absolutely illogical, unless of course the goal is to INCREASE REVENUE, in which case these dermatology providers hit the mark right on target.

So Now What?

I will stay positive! We must stay positive. I continuously position myself strategically to always be successful in providing the best patient care I can.

I have set my boundaries and know what I will be willing to change and what I will stand up to.

Because don’t get me wrong, I am flexible and adaptable, but when someone crosses the line with my core values? I will stand up for my principles. I hope the new administrators are able to take guidance from their new medical director and remember that it is the healthcare providers that ultimately know how to provide excellent care and keep both healthcare providers and their patients happy.

In the meantime, as I wait for the changes to begin (they have already begun), I plan to continue working hard in research in addition to my clinic.

I also plan to expand my repertoire of patient care tools, in addition to my coaching work:

Helping nurses, NPs and PAs find their calling in dermatology and stay true to their core values as well.

Stay tuned as I share more about this journey into PE derm practice! Our MANDATORY meeting to meet our PE partners is this Thursday. I’ll let you know how it goes!

Buckle up, cause

here we go!!

What are your thoughts about private equity investors being in control of medical practices? How does it make you feel as a healthcare provider or patient?

1 Comment

  1. Cristina Molina

    Amazing article!!! I used to work for a surgeon when this trend was starting. Your stand reminds me his. Patient’s Care came always first. And remember his frustration at the hospital when his patients had been wheeled away from their rooms for unnecessary testing without his consent, just hours after a procedure. He got tired of complaining to the administration. Eventually, we got it!!! Their concern was not the patient, but the “money making machine” they had with the guys ordering the tests who also charged for reading them. It was the beginning of corporate medicine.

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Patricia M. Delgado

DNP, AGPCNP-BC, DCNP
Dermatology Nurse Practitioner, Entrepreneur, Real Estate Investor, and Speaker

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