The future of private practice neurosurgery and the pitfalls of private equity

John M. Abrahams New York Brain & Spine Surgery, West Harrison, New York

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  • 1

    Mikhail C, Shankar D, Taree A, et al. Trends in private equity acquisition of orthopaedic surgery practices in the United States. J Am Acad Orthop Surg Glob Res Rev. 2021;5(12):e21.001628.

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  • 2

    Huber M, Orosz E. Health expenditure trends in OECD countries, 1990-2001. Health Care Financ Rev. 2003;25(1):122.

  • 3

    Sorkin AR. HCA buyout highlights era of going private. New York Times. July 25, 2006. Accessed June 27, 2023. https://www.nytimes.com/2006/07/25/business/25buyout.html

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  • 4

    Cha EDK, Lynch CP, Hrynewycz NM, et al. Spine surgery complications in the ambulatory surgical center setting: systematic review. Clin Spine Surg. 2022;35(3):118126.

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  • 5

    Medscape Physician Compensation Report 2019. Medscape. Accessed June 27, 2023. https://www.medscape.com/slideshow/2019-compensation-overview-6011286

  • 6

    Doximity report shows neurosurgery tops physician compensation. AANS. Accessed June 27, 2023. https://www.aans.org/en/DC-E-News/2022/January-E-News/Doximity-Report-Shows-Neurosurgery-Tops-Physician-Compensation

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  • 7

    Vallejo FA, Eichberg DG, Morell AA, et al. Same-day discharge after brain tumor resection: a prospective pilot study. J Neurooncol. 2022;157(2):345353.

  • 8

    Siddiqui N, Reddy VP, Rogers JL, et al. Trends in matriculation from neurological surgery training programs into academic versus private practice. World Neurosurg. 2022;165:e635e642.

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  • 9

    Singh R, Richter KR, Pollock JR, et al. Trends in neurosurgical practice size: increased consolidation 2014-2019. World Neurosurg. 2021;149:e714e720.

  • 10

    Tan S, Seiger K, Renehan P, Mostaghimi A. Trends in private equity acquisition of dermatology practices in the United States. JAMA Dermatol. 2019;155(9):10131021.

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  • 11

    Rychlewski C, Balshem D. This joint is jumping: PE firms knee-deep in orthopedic space. Forbes Magazine. August 14, 2019.Accessed June 27, 2023. https://www.forbes.com/sites/mergermarket/2019/08/14/this-joint-is-jumping-pe-firms-knee-deep-in-orthopedic-space/

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  • 12

    O’Hanlon CE, Whaley CM, Freund D. Medical practice consolidation and physician shared patient network size, strength, and stability. Med Care. 2019;57(9):680687.

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  • 13

    Scheffler RM, Alexander LM, Godwin JR. Soaring private equity investment in the healthcare sector: consolidation accelerated, competition undermined, and patients at risk. SSRN. Published online June 4, 2021. Accessed October 4, 2023. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3860353

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  • 14

    Sanger-Katz M, Creswell J, Abelson R. Mystery solved: private-equity-backed firms are behind ad blitz on ‘surprise billing.’ New York Times. September 13, 2019.Accessed June 27, 2023. https://www.nytimes.com/2019/09/13/upshot/surprise-billing-laws-ad-spending-doctor-patient-unity.html

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  • 15

    Powers BW, Shrank WH, Navathe AS. Private equity and health care delivery: value-based payment as a guardrail? JAMA. 2021;326(10):907908.

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    Patel AA, Fernandez C, Mazmudar A. Private equity and its emergence in orthopaedics. J Am Acad Orthop Surg. 2021;29(20):e1005e1012.

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    Dyrda L. Optum has 5.4% of US physicians & 5 more notes. Becker’s ASC Review. Published March 8,2021. Accessed June 27, 2023. https://www.beckersasc.com/asc-news/optum-has-5-4-of-us-physicians-5-more-notes.html

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  • 18

    U.S. Ambulatory Surgical Centers Market Size, Share &. COVID-19 Impact Analysis, By Type of Center (Single-specialty and Multi-specialty), By Ownership (Physician-owned, Hospital-owned, and Corporate-owned), By Application (Diagnostic Services and Surgical Services), and Forecast, 2021-2028. Fortune Business Insights. Accessed June 27, 2023. https://www.fortunebusinessinsights.com/enquiry/request-sample-pdf/u-s-ambulatory-surgical-centers-market-106323

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  • 19

    Tozzi J. UnitedHealth chases 10,000 more doctors for biggest U.S. network. Bloomberg News. Published March 5, 2021. Accessed June 27, 2023. https://www.bloomberg.com/news/articles/2021-03-05/unitedhealth-s-deal-machine-scoops-up-covid-hit-doctor-groups

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  • 20

    Nikpay SS, Richards MR, Penson D. Hospital-physician consolidation accelerated in the past decade in cardiology, oncology. Health Aff (Millwood). 2018;37(7):11231127.

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  • 21

    Fenton JJ, Jerant AF, Bertakis KD, Franks P. The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med. 2012;172(5):405411.

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  • 22

    Kane CK. Policy Research Perspectives. Recent changes in physician practice arrangements: private practice dropped to less than 50 percent of physicians in 2020. American Medical Association. Accessed October 4, 2023. https://www.ama-assn.org/system/files/2021-05/2020-prp-physician-practice-arrangements.pdf

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  • 23

    Cloud-Moulds PJ. Calculating the right number of staff for your medical practice. Physicians Practice. Published July 12, 2014. Accessed June 27, 2023. https://www.physicianspractice.com/view/calculating-right-number-staff-your-medical-practice

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  • 24

    Cha EDK, Lynch CP, Hrynewycz NM, et al. Spine surgery complications in the ambulatory surgical center setting: systematic review. Clin Spine Surg. 2022;35(3):118126.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Americal Medical Assocation. AMA analysis shows most physicians work outside of private practice. Published May 5, 2021. Accessed October 19, 2023. https://www.ama-assn.org/press-center/press-releases/ama-analysis-shows-most-physicians-work-outside-private-practice

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  • 26

    Heaton MN. NERVES Summary of Survey Results. Published April 22, 2021. Accessed October 19, 2023. https://nerves.memberclicks.net/assets/docs/NERVES%20Presentation%20Preliminary%20%202021%20%28006%29.pdf

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  • 27

    Sanger-Katz M, Creswell J, Abelson R. Mystery solved: private-equity-backed firms are behind ad blitz on ‘surprise billing.’ The New York Times. September 19, 2019. https://www.nytimes.com/2019/09/13/upshot/surprise-billing-laws-ad-spending-doctor-patient-unity.html

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  • 28

    Morgenson G, Rosner J. These Are the Plunderers: How Private Equity Runs—and Wrecks—America. Simon & Schuster; 2023.

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