Thread

1. NegativeK · 1789944184 · focus · HN ↗

   Can someone steelman private equity, please? I'm honestly looking for the upsides (for non-investors) of when PE moves into an industry like medicine and begins buying up businesses that traditionally aren't already large chains.

   I already hear the downsides frequently from someone whose work is directly affected.

   1. prplfsh · 1789946278 · focus · HN ↗

      Many medical practices (and other businesses) are poorly operated and administered. I think of my dentist: terrible website (even by 1995 standards), awful at follow up, weird insurance coverage (since she doesn't have time to follow up with new plans it seems) and almost no appointment reminders. There are obvious things to do that could drive business for her.

      It makes sense to me that someone could come in and say "hey, let me run the business + finance side of the house while you practice medicine" and at least on paper I can see a real world where that works out for everybody.

      Of course, soon you end up with dentists pushing unnecessary procedures and more, so it doesn't always works out that way.

      1. shermantanktop · 1789947004 · focus · HN ↗

         Improving efficiency and optimizing profit are two overlapping segments on the road to crap. It’s not easy to stop the car once you put the bean counters in the driver's seat. If a company is able to do so, it’s usually because there’s a strong leader or culture to resist the slide. But otherwise it’s a thousand small decisions that all seem reasonable on their own.
      2. NegativeK · 1789948295 · focus · HN ↗

         In human med, it's a pretty standard practice to offer a management company 10% ownership for them to handle the business shit.

         I'm not arguing with you; I'm legitimately curious what happened to that model and why PE has swooped in as more attractive to doctors. Maybe it's the payout and/or the fact that they don't have to handle business owner decisions at _all_ anymore?

         1. alex43578 · 1789957637 · focus · HN ↗

            Those are two different things, typically. A business manager taking 10% means they're still running the practice day to day and seeing patients. PE will come in to buy the entire practice from the doctor/dentist/vet that owns the practice, buying it from them entirely.

            1. NegativeK · 1790080573 · focus · HN ↗

               Oh, definitely. But what my parent comment was suggesting that PE do for their dentist is what 10% business management companies were already doing.

               An acquaintance doctor in vet med was pitched 10% ownership in a practice buyout; PE would do business management. The doctor countered with the PE company getting 10%, since they won't be doing any medicine. The PE company declined.

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