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Physician Engagement With Private Equity Firms. 医生与私募股权公司的合作。
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.341
Amber R Comer, Jake Young
{"title":"Physician Engagement With Private Equity Firms.","authors":"Amber R Comer, Jake Young","doi":"10.1001/amajethics.2025.341","DOIUrl":"https://doi.org/10.1001/amajethics.2025.341","url":null,"abstract":"<p><p>Private equity investments in health care raise several clinical and ethical questions about private equity's influence on clinicians' practices. This article canvasses how these questions are navigated in AMA Code of Ethics opinions.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E341-345"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Should Private Equity Firms Own Residency Slots? 私募股权公司是否应该拥有居留权？
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.325
Mark Varvares, Jad F Zeitouni, Stacey Gray
{"title":"Should Private Equity Firms Own Residency Slots?","authors":"Mark Varvares, Jad F Zeitouni, Stacey Gray","doi":"10.1001/amajethics.2025.325","DOIUrl":"https://doi.org/10.1001/amajethics.2025.325","url":null,"abstract":"<p><p>Private equity (PE) margin maximization and profit-making strategies focus on acquisition, short-term ownership, and sale of health care entities, including residency program opportunities. PE ownership durations generally have 3 purposes: reduce staff, sell assets, and refinance debt. The purpose of graduate medical education (GME), however, is to provide learning and training opportunities in a variety of clinical, academic, technical, and research domains. This article offers examples of PE involvement in residency training and argues that PE and GME purposes not only conflict but add instability to graduate medical education learning environments. This article also suggests reasons why PE investment in GME, including residency \"slot\" ownership, undermines academic health centers' ethical and educational obligations to trainees in their GME programs.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E325-332"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health Inequity Profiteering by Private Equity Firms. 私募股权公司的医疗不公平暴利。
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.361
Thomas Statchen, Colleen M Grogan
{"title":"Health Inequity Profiteering by Private Equity Firms.","authors":"Thomas Statchen, Colleen M Grogan","doi":"10.1001/amajethics.2025.361","DOIUrl":"https://doi.org/10.1001/amajethics.2025.361","url":null,"abstract":"<p><p>This article explains how some investment practices of private equity (PE) firms generate profit by taking advantage of inequitably underserved patients in the US health care system. In particular, patients with general medical or mental health needs who seek care at safety-net hospitals or in carceral facilities and patients seeking mental health services are vulnerable to the following PE strategies: purchasing low-quality practices where patients lack opportunities to get care elsewhere, maximizing consolidation of deeply fragmented health service delivery systems, and avoiding accountability for poor-quality service that results from regulatory opacity. For each problem area, the article offers a policy response to mitigate harm to patients.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E361-368"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When Does Private Equity Ownership of Physician Practices Violate "First, Do No Harm"? 私募股权在什么时候违反了“优先不伤害”原则？
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.376
Preethi Subbiah, Richard M Scheffler
{"title":"When Does Private Equity Ownership of Physician Practices Violate \"First, Do No Harm\"?","authors":"Preethi Subbiah, Richard M Scheffler","doi":"10.1001/amajethics.2025.376","DOIUrl":"https://doi.org/10.1001/amajethics.2025.376","url":null,"abstract":"<p><p>One driver of the corporatization of medicine has been private equity (PE) firms' acquisition of physician practices. This article describes when PE firms' investments in or ownership of physicians' practices undermine health service delivery operations and patients' outcomes to the point of violating primum non nocere, a key ethical requirement for physicians to prioritize harm avoidance in practice. This article then suggests how to balance the interests of health care as a commercial enterprise with health care as a critical human right.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E376-381"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Private Equity Undermines Rural Health Equity. 私募股权如何破坏农村医疗公平？
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.369
Jake Young
{"title":"How Private Equity Undermines Rural Health Equity.","authors":"Jake Young","doi":"10.1001/amajethics.2025.369","DOIUrl":"https://doi.org/10.1001/amajethics.2025.369","url":null,"abstract":"<p><p>Capital and staff shortages have forced many rural hospitals to close. Private equity investment in rural hospitals has been one solution to these problems. This article argues, however, that private equity firms' business practices, especially shortening acquisition-to-sale time and maximizing profit margin, generate overall health care market instability. This consequence can be particularly devastating for people living in rural areas of the United States, who report worse health outcomes, more chronic disease, and more restricted access to health services than people in urban or suburban regions.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E369-375"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is Pursuing Profit Commensurable With Providing Good Health Care? 追求利润与提供良好的医疗保健是否相称？
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.305
Jad Zeitouni
{"title":"Is Pursuing Profit Commensurable With Providing Good Health Care?","authors":"Jad Zeitouni","doi":"10.1001/amajethics.2025.305","DOIUrl":"https://doi.org/10.1001/amajethics.2025.305","url":null,"abstract":"","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E305-307"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Should We Assess Quality of Health Care Services in Organizations Owned by Private Equity Firms? 我们应该如何评估私募股权公司拥有的组织的医疗保健服务质量？
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.385
Ambar La Forgia, Ryan C McDevitt
{"title":"How Should We Assess Quality of Health Care Services in Organizations Owned by Private Equity Firms?","authors":"Ambar La Forgia, Ryan C McDevitt","doi":"10.1001/amajethics.2025.385","DOIUrl":"https://doi.org/10.1001/amajethics.2025.385","url":null,"abstract":"<p><p>This article assesses research on private equity ownership's influence on health care quality. A review of several prominent studies supports the conclusion that private equity ownership does not have a universally positive or negative effect. Past research has found that providers backed by private equity generally have mixed quality outcomes post acquisition, depending on the sector and measures evaluated. This article outlines ways in which research findings are misconstrued and cautions against drawing conclusions from a narrow sample of literature about private equity based on studies in one sector.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E385-391"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What Are Physicians' Duties to Patients When They Sell Their Practices? 当医生出售他们的诊所时，他们对病人的责任是什么？
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.308
Lucy Xu, Matthew R Naunheim
{"title":"What Are Physicians' Duties to Patients When They Sell Their Practices?","authors":"Lucy Xu, Matthew R Naunheim","doi":"10.1001/amajethics.2025.308","DOIUrl":"https://doi.org/10.1001/amajethics.2025.308","url":null,"abstract":"<p><p>Physicians have fiduciary duties to respond with care to patient's clinical needs and vulnerabilities, whereas private equity (PE) companies have no such ethical or legal duties to patients and strive to maximize financial returns for their investors. This commentary on a case considers ethical conflicts of interest that arise when physicians sell their practices to PE firms and describes what physicians should consider when selling to fundamentally profit-driven entities.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E308-317"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Current Legal Tools Respond Adequately to Risks of Private Equity Investment in Health Care? 当前的法律工具能否充分应对医疗领域私募股权投资的风险？
AMA journal of ethics Pub Date : 2025-05-01 DOI: 10.1001/amajethics.2025.333
Robert I Field
{"title":"Can Current Legal Tools Respond Adequately to Risks of Private Equity Investment in Health Care?","authors":"Robert I Field","doi":"10.1001/amajethics.2025.333","DOIUrl":"https://doi.org/10.1001/amajethics.2025.333","url":null,"abstract":"<p><p>As private equity (PE) funds acquire a growing share of America's health care system, their focus has expanded to include not only hospitals and nursing homes but also physician practices. Some PE acquisitions have infused much-needed capital into resource-starved entities, but others have led to higher prices, diminished quality of services, and billing fraud. Some PE acquisitions have also forced viable entities into bankruptcy by stripping their real estate and other assets. This article explains how legal and regulatory responses to these outcomes can be impeded by corporate structures that PE funds commonly use to obscure responsibility. It also suggests reforms that could strengthen enforcement capacity.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 5","pages":"E333-340"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Should Physicians Manage Traumatic Injuries Sustained During Incarceration? 医生应如何处理监禁期间遭受的外伤？
AMA journal of ethics Pub Date : 2025-04-01 DOI: 10.1001/amajethics.2025.242
Wynne Q Zhang, Lucas A Dvoracek
{"title":"How Should Physicians Manage Traumatic Injuries Sustained During Incarceration?","authors":"Wynne Q Zhang, Lucas A Dvoracek","doi":"10.1001/amajethics.2025.242","DOIUrl":"10.1001/amajethics.2025.242","url":null,"abstract":"<p><p>Patients who are incarcerated experience severely restricted autonomy and are thus extremely vulnerable. This commentary on a case offers longitudinal, long-term postsurgical trauma-informed care recommendations and starts with a working assumption that, when injuries sustained during incarceration require surgery and hospitalization, patients' rights to evidence-based standard of care that would be given to any other patient should not be compromised. Yet surgical care of traumatically injured patients who are incarcerated can be ethically and clinically complex due to their status as wards of the state, which abrogates their liberty to make their own health decisions. Patients who are incarcerated also have preexisting trauma and are at risk for violence and persistent traumatic stress.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 4","pages":"E242-248"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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