If you’re wondering why you don’t hear more about private equity from physicians, it’s because some of them receive significant financial gain from selling to PE and the ones who don’t, the doctors who have to work as an employee under PE, are contractually prohibited from speaking out against ole Barty Banks. It’s really bad.
What about physicians who don't agree with mask or COVID vaccine mandates? The media crucifies them for even daring to speak their opinion because they're ostensibly "against science". But science involves the process of constant criticism of established orthodoxies and refinements for better outcomes overall. Scientific healthcare professionals aren't out to deify, but always question and critique.
@@android199ios25I don’t blame them, people will do what they need to do to take care of themselves and their families, but those decisions have consequences for patient care
I interviewed with a private equity group, and the physicians interviewing me had the same "Get Out" vibes. When one of them offered to put in a good word for me with a non-private equity group in the area, one of the corporate recruiters instantly entered the room and sat in on the remainder of the interview. It was apparent she had been eavesdropping. I just hope that doc didn't get in too much trouble. Needless to say I did not take that job.
I want to see Banks wheeled into his own “investment” with locked in syndrome and no ID, treated just like he demands patients who can’t afford treatment are treated.
No character in the Glaucomverse has a more punchable face than Bartholomew Banks. Which is funny, because he has the same face as every other character.
I'm and MBA student, and I have a few colleagues looking into PE. Very proud of my accounting prof who, in a required class, called our private equity for "sucking the life" out of what they buy and "hollowing out" the workforce. The finance bros were so shell shocked it was incredible.
Reminds me of what I like to call the "Costco Effect." People want to optimize Costco, to pay the workers less, increase prices, and trim the fat. The thing is, people go to Costco because the people who work there are happy to work there and because the prices are good. If you incrementally make it a worse place to be, people won't want to go there. Instead of looking at next-quarter gains, look at multi-year continued success. It's healthier for all.
@@ae3qe27u3 That would require that they actually care about the long-term prospects of the business and not just getting as much profit as fast as possible and getting out before the whole thing collapses.
I just finished my MBA last month, and my M&A professor ripped into PE. I work in PE all my colleagues are finance bros, and I 110% take my professor’s side Private equity IS soul sucking
As a software engineer I too despise the finance bros. You can only imagine how terrible their technically inept ideas are. At least I don't have to deal with the most morally bankrupt among them though, but I feel for the poor hospital professionals. I only have to deal with finance bros running with as much direction about technology as chickens without their heads and that's terrible already.
In international waters... with a mysteriously unregistered ship nearby that had absolutely nothing to do with it... and was miraculously able to save only the lives of the working-class staff... such a tragic hypothetical event.
Lawmakers care about what gets them reelection wins. If they don’t get reelected they can’t do anything at all. Lawmakers with few exceptions . Want something to get changed… get people to care. Also politics is a very very deep topic with vast complexity and rather than studying and understanding it many are brainwashed to hate it and write it off instead to become educated and wade in to play. Also we tell great lies in this society as to the general cognitive functioning of adults. Approximately 25 percent of adults in the US aren’t literate or understand basic problem analysis beyond 3rd grade level with some somewhat small variation from state to state in the data and the given nature of a particular study. We pretend to walk among mostly stable adults with decent reasoning skills but it’s sadly far from true.
Imagine if doctors weren’t so drained from burnout that they actually had the will to fight against the systemic inferiority of the care and get a reminder that the medical errors and bad outcomes impact the patients most of all. The medical community general acceptance and apathy and total disconnect from the actual delivered product is just as bad of a mentality as the private equities.
@@lijohnyoutube101 Private equities don't do this out of a mentality though. They're doing it because thats literally what the system calls for, its in their nature as a business offering a service to make as much profit as they can. The medical community need to work to survive, I dont think theres much they can do to address private equities.
@@hongo9111 absolutely it’s a business model I COULD not agree more…but it’s a business model BECAUSE that mentality is allowed to exist. The business exists because it provides benefits for some in the way of profits. If the mentality wasn’t accepted people wouldn’t work there, regulations would exist to cease activities that actively cause harm, etc etc Evil exists in trillions of ways in our society and monsters justify, and the weak benefit and turn the other cheek and few with power raise their voices as having power often is obtained from a balance of control and not rocking the boat. What exists in a society is what happens because we all allow it to exist.
I went through this with my doc (medical assistant). He was private practice internal medicine, sold to Kennedy, which was bought out by one corporation, which was then in turn bought out by another. Corporate Healthcare is such a nightmare 😫
Omg I relate so much to this. Im 🤏this close to quitting my job because of this same reason. The peoples lives we save.. the look in their eyes when they see the final bill.. knowing they may have nothing to go back to.... haunts me.. literally haunts.
I love these “insights into the reality of commercial medicine” videos you do. I’ve watched dozens if not hundreds of your vids and I remember aspects of them, the characters, the humor… but the one I remember best and most entirely is a doc trying to get a procedure approved from the insurance call center… what’s sad is that as funny as they are, they don’t detract from the truth of the thing: Our medical care, insurance, regulatory, and pharma systems are ALL so fucked up we may never be able to fix them… and that’s heartbreaking. 💔
@@Birdsong-Annalee I agree with that statement completely, but the people who would be setting those regulations are controlled by greed. We could fix it, it's not broken beyond repair. The people who's job is to fix it are the ones broken.
Every attempt in the past two decades was killed in house committees, there will likely be more progressive people in office in the next few cycles so we might be able to have serious chances soon
Will not lie, as a resident, one of the dreaded things we have to do some times is call insurance companies - especially when we're pretty sure a high risk patient may not be able to do it themselves. One of my proudest moments remains getting PA for a VERY NECESSARY med for a patient about to be discharged from the hospital in the evening. It meant staying late, but getting that "ok" from the insurance rep gave me peace of mind that night that was priceless.
@@Birdsong-Annalee you just said exactly the same thing they said… we need regs to manage corporate greed and price gouging. I’m confused what you’re taking issue with… you seem to be in full agreement with each other.
Thank you for shining light on the greed that has infiltrated HC. No human was born wanting financial ruin from a surprise medical condition. It is unethical to literally bleed people dry. I believe that if we keep shining light on this matter (ESPECIALLY AS MORE BOOMERS ENTER HC FACILITIES); people will see the need for reform.
I'm from Germany 🇩🇪 and our healthcare system really isn't perfect, but this makes me wanna cry 😢. Guys, I hope one day you all have universal healthcare. You deserve it 😘. Much love ❤
@@Birdsong-Annaleeour system recently allowed private equity to buy/run doctor‘s practices. so, the GP around the corner might work for PE. clearly taking away the wrong lessons from the US.
@@julesk1567The problem is that any government system is going to be run by people, and there's a percentage of humanity who can always be bought, even if it means leaving the people they ostensibly serve vulnerable to financial predation.
@@julesk1567 yes, but we also had private hospitals for a long time. I absolutely believe that hospitals should be municipally run, but the private hospitals are not running amok. They negotiate their payments with the association of public health insurance and _they_ have a strong hand.
I am from Canada, just started a residency in an American program. The very 1st lecture we had during orientation was about proper charting to ensure "maximum billing." All tests and diagnostic procedures in EPIC have price tags, and costs are horrendous. A pelvic ultrasound is over 5K, although one could get a CT scan with reading in another state for $250. Some attendings are cognizant about a possible financial burden for a patient, but some care only about "maximum billing." It is hard to process.
No, thanks. I'd rather get surgery when I actually need it and have increased chances of cancer survival if the disease ever finds me. Redistributing an out-of-control cost is almost never an effective solution; it only costs the average, tax-paying citizen far more than it should. The first rule of economics is supply and demand. Government invasion of corporations always hampers supply and drives cost increases. Then, the imbecilic leftists resolve to redistribute the problem instead of addressing it. If you want to decrease the costs of healthcare overnight, stop treating everyone who walks into an ED with a jammed toe having no intention whatsoever to compensate highly educated and skilled employees for their time and services.
There's nothing inherently wrong with private healthcare. Up until very recently (1970s) it was perfectly affordable but then hospitals started becoming corporatized at the same time the government began imposing one regulatory hurdle after the next, driving up patient care costs. Just like with seemingly every other sector, hospitals are being consolidated into the ownership of fewer and fewer hands which, in turn become more and more distant from their customers/patients. Really, we should be looking to how things were done in the past, before costs started skyrocketing and attempt to recreate those conditions instead of another system.
I spent 1 year being instructed to risk my PA license, and more importantly patient safety, working with a company that was acquired by a private equity firm while I was in contracting/credentialing. I did what I could to speak up and do right by my patients and resigned with my soul mostly intact the day my contract expired. Never. Again.
As a doc and PNHP member I'm so thrilled to see you use your platform to put out these messages! People need to see how bad things are. Hopefully they will vote change!
We need greed out of the equation to preempt those who prioritize wealth over health. Thank you for shining a light on inequities so we can fix our system.
THIS!!! This right here is why as a non-medical person no longer trusts hospitals. I'm sure there are so many AMAZING doctors, nurses, and staff, but they must follow protocol.
I just have to appreciate the banner at the bottom that says "From a doctor licensed in the US." The best comedy is the closest to the truth, and sir, this is nervous laughter.
Getting a hard truth across without breaking character or losing the light tone? Frkn genius. Comedy really is the hardest art. Well done, Dr G. And I'm an old ER nurse, so i don't compliment doctors! 😂
As I listened, I could feel reactions well up like anger, fear, sadness and, finally, some hope. Thank you, Dr. Glaucomflecken. That was quite a scary trip and well worth the ride.
My husband still lives in the US, I am in Canada. The health care situation there is so very frightening to me. I hope everyday that nothing bad happens to him before he can immigrate.
@@JohanWXC you know nothing about the Canadian health care system. You obviously bought into the propaganda in the USA. There is no income cap. Also why are you bringing in doctors in India? They have a different system to Canada... Plus 200 a day? Bull! At 15 minutes a patient that would take 50 hours. You really have to get off the propaganda and conspiracy theories.
אני מישראל כך שאני לא נתקל לשמחתי הרבה בבעיות האלה בתור רופא.. משמח לראות את הצעד הקטן לרווחת המטופלים. שמח לצפות בתוכן שלך ולצחוק עד עמקי נשמתי.. בהצלחה!!
@@smellypatel5272shut the hell up and focus on your self you piece of shit bastard and stop believing in lies just because you want to always find someone to blame for your issues this is why the youtuber doesn’t like you you act like you are in private equity
I'm currently in law school, but I have a background in the business side of healthcare (not PE though). I've taken several health law courses and the more I learn about PE, the less I like them. And it's not just human healthcare. Our vets are being snatched up too, all over the country. They're pushing profit over everything else, forcing vets to work ridiculous hours, dropping non-money-making services (like boarding animals, especially cats).
I'm a vet with a small private practice. PE has parasitized this profession. They've ruined some good clinics in this area. I'm glad to see that others like yourself are seeing it too. Private equity has ruined a lot of businesses across the spectrum
Bartholomew Banks is utterly committed to the grind. Glauc University's Banks Hospital is lucky to have such a devoted manager. *Biggest /s in human history*
The same thing has been happening in dentistry. Consolidation of dental practices isn't insidious in itself, but when a lot of these practices are being bought up by private equity backed corporations there is a conflict of interest. That being the best interests of the patients we serve vs the best interests of the shareholders.
Just noticed... PE also stands for Pulmonary Embolism, where a clot goes to your lungs, makes your heart useless, and can kill you dead. Great metaphor!
To other doctors in residency out there, you are 100% a fool to join a PE owned group. My last group cut health insurance to increase the bottom line LMAO. Pinching Pennies to make it more profitable and this easier to sell. The challenge - find me 1 single PE doctor who wasn’t bought out (an associate) that says “I love my PE job.” You won’t find it
Thankfully where i live and who i work for in emergency mediicne is really great at standing for affordability for p.t care and striving for making each patient being welcomed! I love where i work. Makes me feel like i actaully make a difference!
Hey Doc, could you per chance link the resources you cited in your short? I have a friend that thinks that PE-acquired health systems perform just as good as independently owned health systems. From the quick google search we did, most economic journals from big name institutions (e.g. UPenn, Harvard) says that "...we did not find any evidence of significant reductions in the most unprofitable service lines." I personally could not review the actual article that they are quoting due to the expensive paywall, so there's definitely room for additional scrutiny. Love to hear your thoughts on this and enjoyed the video as well.
news.ohsu.edu/2022/09/02/study-raises-red-flags-about-corporatization-of-health-care-ohsu-investigator-says this is an article that references the study I’m talking about.
One challenge and the reason why PE sees an opportunity in so many hospitals is that non-profit hospitals often aren't run efficiently. I've seen many non-profits using old protocols that are more expensive rather than current evidence based medicine. Or hospitals having 4+ hip/knee implant vendors because all the docs are 'friends' with their sales reps and the non-profit doesn't worry about profit enough to negotiate harder and not shovel money into the hands of vendors. PE has lots of issues, but let's not pretend that non-profit hospitals don't have their own issues.
@@dalpz205 various structures, but a non-profit who's 'mission' is healthcare for the poor could sell the hospital and use that money to establish a fund that would pay for healthcare for poor people. In theory, it's the same mission, just a conversion of one asset type to another, so no legal issues.
A lot of private medical practices on Long Island have sold to giant non profit health corporations where services can all be referred and performed in house. Most of these mega non profits operate similar to PE. Disingenuous to pick on only PE for being money driven when I could not find an in plan anesthesiologist when having a colonoscopy. A lot of people in the medical field (doctors included) are chasing the dollar.
The government and insurance companies carry much of the blame for the anesthesiologists not being willing to take the poor reimbursements from your insurance for their services. In short, the government sets rates through Medicare (relative value units) to try to establish what relative fees should be for different services. Most insurance companies are lazy and just adopt these same proportions to some degree. As a result, some services are reimbursed very poorly while others are reasonable and others are quite lucrative. I have real world examples of how those fees can be all over the board and make no sense to those involved with the provision of those services. Now, if the GI doctors get reimbursed sufficiently, they will choose to participate with your insurance and their rates of pay. If your insurance reimburses poorly for anesthesia, the anesthesia doctors can choose not to participate with your insurance. It doesn't necessarily make them greedy for not being willing to accept really poor reimbursement for their services.
A dark but genuine question: If a person in US tries to kill himself because of inability to pay student loans, insurance or medical bills and a hospital revives him, can he ever refuse to pay because he didn't ask for it and the hospital bills kind of killed him in the first place? Or are things not THAT bad in the US. Just asking as a foreigner.
No, he'd still owe those bills. If he didn't have insurance and was truly poor, someone at the hospital might help him get setup with a state/ federal option like Medicaid.
The only saving grace is if he signs a DNR! Do Not Resuscitate means the hospital would not bring him back to life. Of course the hospital would then be looking for any next of kin.
Private equity investment companies (e.g. BlackRock) aren't just doing this to healthcare, they're doing it to pretty much every sector across the country. Housing, manufacturing, automotive, etc. Short-term thinking by people whose only concern is the next fiscal quarter, not long-term outlook for the sake of the company/hospital/factory/etc.
These are the most educational - and terrifying - clips, and explain SO much about what we hear in a more general sense regarding US 'healthcare.' Scary, scary, stuff ...
So you're telling me thay you can purposely try to fail this job interview and still get it vause they got no one to work for them and they dont pay you?
I wonder if these are the same financial geniuses who figured out that they can replace doctors with NPs, PAs, CRNAs and bill patients the same. But just think of how good the champagne in their hot tub is.
Don't forget the overwhelming statistics that show for profit health care results is worse outcomes than universal healthcare systems. Higher profits mean lower life expectancies. USA USA...sob
What is interesting is for profit hospitals are almost non existent in Northern California. But in Southern California they are extremely common and may be the majority.
PE typically buys a viable business, then extracts a very large amount of money up front by paying a large equity dividend and taking on a large amount of debt. That debt leverage can only be serviced by underinvesting, run the asset down, push employee wages down, reduce service levels and raise fees. I have seen it time after time in many industries and very often it ends with the company going into liquidation with the employees losing their jobs and customers and suppliers losing money they were owed.
