Private equity’s expansion into orthopedics has drawn its share of scrutiny over the past few years.
Four surgeons say independent practices can learn from PE’s playbook without selling to it. From cost discipline to administrative infrastructure, surgeons say that independent practices do have something to gain from studying how PE-backed groups run.
The catch is that while operational lessons are worth borrowing, giving up clinical control is off the table.
Ask Orthopedic Surgeons is a series of questions posed to orthopedic surgeons and leaders around the country about clinical, business and policy issues affecting orthopedic care. Becker’s invites all orthopedic surgeons and specialists to respond.
Next question: What is one leadership mistake you’ve seen derail an otherwise strong orthopedic practice?
Please send responses to Cameron Cortigiano at ccortigiano@beckershealthcare.com by 5 p.m. Central time on Nov. 16.
Note: Responses were lightly edited for clarity and length.
Question: What is one thing private equity gets right about running a practice that independent physicians should pay more attention to?
Michael Briseño, MD. Orthopedic Surgeon at North Texas Orthopedics & Spine Center (Grapevine, Texas): Private equity can bring capital, infrastructure and operational expertise that help practices grow more efficiently and take administrative burden off physicians. When those resources are used well, physicians can spend more of their time focused on patients instead of managing staffing, technology, contracting and other business functions. There is also value in the discipline that comes with building scalable systems rather than relying on physicians to solve every operational problem themselves. The line has to be clear though. Clinical decisions should remain with physicians, while the business infrastructure around them makes it easier to deliver high-quality care, grow the practice and stay focused on improving patient access and outcomes. You can have sophisticated operations and meaningful scale while still keeping physicians at the center of how the practice is run.
Nicholas Bruggeman, MD. Orthopedic Surgeon at OrthoNebraska (Omaha): One thing private equity gets right is recognizing that strong practice operations matter. Physicians are trained to focus on patient care, but the systems behind that care, from staffing and scheduling to technology and financial planning, directly affect how efficiently a practice runs. The right private equity relationship enables independent physicians to remain focused on their patients and deliver exceptional care instead of trying to manage every business function themselves. When operational decisions are supported by good data and experienced teams, physicians can spend more time building a high-quality practice that is sustainable for the long term.
Amit Jain, MD. Spine Surgeon and Vice President of Care Transformation at Johns Hopkins Medicine (Baltimore): They are effective at eliminating administrative fragmentation by centralizing back-office operations, contracting leverage and supply chain procurement. Independent groups often conflate clinical autonomy with administrative isolation, missing out on economies of scale that protect solvency.
Farzin Kabaei, MD. Orthopedic Surgeon at Docs Health (Los Angeles): They know their numbers. Private equity knows what every case costs, what every contract pays and where the money leaks out. Most surgeons were never taught any of that, and many of us still do not know our true cost for a single joint replacement. You do not have to sell your practice to run it with that kind of discipline. Measure everything, negotiate as a group and treat the business side as seriously as the operating room. Independent groups that do that can compete with anyone.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
