'Time will tell': What will be orthopedic private equity's long-term reputation?

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Private equity in orthopedics has the specialty split on its benefits and concerns. The phenomenon is still relatively new, but some physicians are already thinking about the long-term effect it will have on the industry.

Three spine surgeons discuss how they think private equity will be seen after a decade.

Question: Will orthopedic private equity be seen as a mistake or success in 10 years?

James Chappuis, MD. Spine Center Atlanta: The future of private equity comes down to one question: Are there good checks and balances to ensure the patient and patient care come first? I'm concerned that patient care might be compromised by using it to enhance the company's equity instead of the patient's healing and wellness. 

Vladimir Sinkov, MD. Sinkov Spine (Las Vegas): The answer will depend on who you ask.  The private equity companies will see it as success. In 10 years they most likely will have extracted maximum profits from the medical practices they managed and then have sold them to either insurance companies or large hospital systems — thus further decreasing physician autonomy and patient's ability to choose a doctor they want.

The physicians will see it as a mistake. By then they will have abandoned any hope of practice autonomy or ability to earn profits beyond their basic salary. The patients will have little to no choice of what doctor to see, since it will be directed by their insurance company or by their primary treating provider acting as a "gatekeeper." Since there will be no real market competition, the quality of care will likely diminish, and the costs of care will continue to increase.  

Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): For the first time in three decades, the polled American public has a negative majority opinion of healthcare delivery, yet polling about physicians and their social standing, albeit dropped, yet remains slightly positive. This reporting is the preface as it relates to physician-owned medical facilities and the malingering question of enticement and remuneration. Granted growth in this sector is noted but factors of dwindling reimbursements, community practice standards of care and insurance exclusions are targets of discussion and disclosure. Corporate success is also defined by its foundation and principles, and profits and societal mores conflict repeatedly, while not being compatible or conventional partners.

Locally, a large for-profit system shuttered a number of centers because of bankruptcy issues and were forced to piecemeal liquidate their healthcare entity, leaving thousands of patients and physicians uncovered and jobless. Time will tell.

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