Assessing Private Equity Involvement in Ophthalmology: Parallels With the Past, Concerns for the Future

IF 4.1 1区 医学 Q1 OPHTHALMOLOGY American Journal of Ophthalmology Pub Date : 2024-10-05 DOI:10.1016/j.ajo.2024.09.026
Jonathan D. Groothoff , David J. Browning
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Abstract

Purpose

To discuss the history and current state of private equity in ophthalmology, and to explore potential implications for ophthalmology practices, physicians, and patients.

Design

Perspective.

Methods

Selected articles in ophthalmology and non-ophthalmology medical literature were reviewed, and commentary is provided based on the authors’ experiences.

Results

Investment in ophthalmology appeals to private equity firms because of high procedural volumes, fragmented private practices, opportunities for real estate ownership, and an aging population in need of eye care. As a result, acquisition of private practices by large private equity companies has swelled since 2015. Metropolitan areas and practices that possess ambulatory surgical centers or a high proportion of retina surgeons receive the greatest investment. However, little objective data exist regarding the benefits of this trend. Initial research suggests that private equity ownership may have a negative impact on patient care through greater costs, shorter appointments, and fewer Medicare/Medicaid patients seen. Skeptics of private equity also highlight concerns that include financial risk falling primarily on the acquired practice itself, a short-term business approach that rewards profit maximization, and the erosion of physician autonomy. Furthermore, young ophthalmologists express reservations about working for private equity firms. In all, 78% of trainees indicated that they would not consider employment by a private equity–owned practice, and 81.4% of vitreoretinal fellows voiced concerns about autonomy and job security. Proposed legislation aimed at limiting private equity acquisitions is currently under review at the statewide level, adding additional uncertainty to the future of private equity involvement in ophthalmology.

Conclusions

Although investment by private equity offers potential financial rewards and operational improvements for practices, it also raises significant concerns reminiscent of those experienced by physician practice management companies in the 1990s. Non-anecdotal data are needed to assess the benefits and future of private equity involvement in ophthalmology.
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评估私募股权投资在眼科领域的参与情况:与过去的相似之处,对未来的担忧。
目的:讨论眼科领域私募股权的历史和现状,探讨其对眼科医疗机构、医生和患者的潜在影响:设计:透视:方法:回顾眼科和非眼科医学文献中的部分文章,并根据作者的经验进行评论:由于眼科手术量大、私人诊所分散、房地产所有权机会多以及需要眼科护理的人口老龄化,眼科投资对私募股权公司很有吸引力。因此,自 2015 年以来,大型私募股权公司对私人诊所的收购激增。拥有门诊手术中心或视网膜外科医生比例较高的大城市地区和诊所获得的投资最多。然而,有关这一趋势的益处的客观数据却很少。初步研究表明,私募股权可能会增加成本、缩短预约时间、减少医疗保险/医疗补助患者数量,从而对患者护理产生负面影响。对私募股权持怀疑态度的人还强调了一些顾虑,其中包括财务风险主要由被收购诊所本身承担、奖励利润最大化的短期经营方式以及对医生自主权的侵蚀。此外,年轻的眼科医生对为私募股权公司工作持保留态度。78%的受训人员表示不会考虑受雇于私募股权所有的诊所,81.4%的玻璃体视网膜研究员表达了对自主权和工作保障的担忧。目前,全州正在审议旨在限制私募股权收购的立法提案,这为私募股权参与眼科领域的未来增添了更多不确定性:结论:尽管私募股权投资为眼科医疗机构带来了潜在的经济回报和运营改善,但它也引发了许多令人担忧的问题,这些问题与 20 世纪 90 年代医生管理公司所经历的问题如出一辙。我们需要一些非传闻性的数据来评估私募基金参与眼科业务的益处和前景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.20
自引率
7.10%
发文量
406
审稿时长
36 days
期刊介绍: The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.
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