Perceptions of Private Equity in Private Practice: Insights from Ophthalmology

Abstract

Private equity (PE) has a significant presence in private practice medicine, especially ophthalmology. Semi-structured interviews were conducted with six private practice ophthalmologists from PE-backed and non-PE-backed settings. Views on PE’s benefits, areas for improvement, perceived or directly experienced influence on clinical practice, alignment with delivering quality care, legislative regulation, and patient cost burden changes were assessed. Three domains and seven themes were identified. The operations domain included themes of logistics and management structure. The profitability domain included themes of physician compensation, competitive advantage, and revenue. The clinical practice domain included themes of physician autonomy and quality of care. Participants disclosed general agreement that PE can align with medicine’s goal of quality care delivery, endorsement of little to no regulation of PE, and mixed views on PE’s effects on patient cost. PE’s favorability was influenced by physician input in decision-making processes, mission alignment between physicians and PE, and afforded clinical autonomy. Variable management styles and secondary buyouts raise concerns about sustainability for practices that will be subject to changing PE management.