PURPOSE To discuss the history and current state of private equity in ophthalmology and explore potential implications for ophthalmology practices, physicians, and patients. DESIGN Perspective. METHODS Review of selected articles in ophthalmology and non-ophthalmology medical literature and commentary based on the authors' experiences. RESULTS Investment in ophthalmology appeals to private equity firms because of high procedural volumes, fragmented private practices, opportunities for real estate ownership, and an aging population in need of eye care. As a result, acquisition of private practices by large private equity companies has swelled since 2015. Metropolitan areas and practices that possess ambulatory surgical centers or a high proportion of retina surgeons receive the greatest investment. However, little objective data exists regarding the benefits of this trend. Initial research suggests that private equity ownership may negatively impact patient care through greater costs, shorter appointments, and fewer Medicare/Medicaid patients seen. Skeptics of private equity also highlight concerns that include financial risk falling primarily on the acquired practice itself, a short-term business approach that rewards profit maximization, and the erosion of physician autonomy. Furthermore, young ophthalmologists express reservations about working for private equity firms. 78% of trainees indicated they would not consider employment by a private equity owned practice and 81.4% of vitreoretinal fellows voiced concerns about autonomy and job security. Proposed legislation aimed at limiting private equity acquisitions is currently under review at the statewide level, adding additional uncertainty to the future of private equity involvement in ophthalmology. CONCLUSION Although investment by private equity offers potential financial rewards and operational improvements for practices, it also raises significant concerns reminiscent of those experienced by physician practice management companies in the 1990s. Nonanecdotal data is needed to assess the benefits and future of private equity involvement in ophthalmology.

中文翻译：

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评估私募股权参与眼科：与过去的相似之处，对未来的担忧。


目的讨论眼科私募股权的历史和现状，并探讨对眼科实践、医生和患者的潜在影响。设计视角。方法 根据作者的经验回顾眼科和非眼科医学文献中的精选文章和评论。结果 由于程序量大、私人诊所分散、房地产所有权机会以及需要眼科护理的人口老龄化，眼科投资对私募股权公司有吸引力。因此，自 2015 年以来，大型私募股权公司对私人诊所的收购激增。拥有流动手术中心或视网膜外科医生比例较高的大都市地区和诊所获得的投资最多。然而，关于这一趋势的好处的客观数据却很少。初步研究表明，私募股权所有权可能会对患者护理产生负面影响，因为成本更高、预约时间更短、医疗保险/医疗补助患者就诊人数更少。对私募股权的怀疑论者还强调了一些担忧，包括主要由所收购的诊所本身带来的财务风险、奖励利润最大化的短期商业方法以及医生自主权的侵蚀。此外，年轻的眼科医生对在私募股权公司工作持保留态度。 78% 的学员表示，他们不会考虑受私募股权公司雇用，81.4% 的玻璃体视网膜研究员表达了对自主权和工作保障的担忧。旨在限制私募股权收购的拟议立法目前正在全州范围内进行审查，这给私募股权参与眼科的未来增加了额外的不确定性。 结论 虽然私募股权投资为诊所提供了潜在的财务回报和运营改进，但它也引起了人们对 20 世纪 90 年代医生诊所管理公司所经历的重大担忧。需要非轶事数据来评估私募股权参与眼科的好处和未来。