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Some private equity firms are furious over a paper in a dermatology journal

nytimes.com

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Re: Some private equity firms are furious over a paper in a dermatology journal

#131

Post by adrian_mrd »

ReallyAnonymous wrote: post #63
copper_think wrote: post #11

What is the value that private equity and/or VC are adding to dermatology? I guess what I'm asking is, why would the physicians be interested in sharing some portion of their income with these non-physicians? Medicine, like other guild professions like law, dentistry, and accounting, is an enterprise which seems to naturally fit the partnership model instead.

I am a general surgeon employed by a hospital system in the southeast. PE / VC don't add anything other than trying to skim a profit off the top of medicine, like any other capitalist. Dermatology is a lucrative practice. They don't have to work in hospitals, so they set their own hours. VC/PE's are doing the long game - purchase a practice (dermatology / anesthesiology, orthopedics ) and reward the current partners…

Thanks for sharing this. It was a great appendum to the article and useful to understand the practicalities of how some surgeries/appointments in the USA medical system are funded (and how some medical practices/clinics are private equitied).

Re: Some private equity firms are furious over a paper in a dermatology journal

#132

Post by mikeash »

eesmith wrote: post #123
mikeash wrote: post #121

Earlier quoted context omitted.

I don’t quite get your point. It’s bizarre and nonsensical in this case, but really useful in other cases, so...? I don’t know how that sentence ends.

So for consistency's sake it's better to just always list allergens, rather than have the regulations say "except when it's bizarre and nonsensical." Otherwise, someone has to decide where that boundary is.

I don’t think it’s really that hard to draw the line. You can still err heavily on the side of safety while not requiring a bag of nuts to warn about the nuts it contains. But our legal system doesn’t go for that sort of nuance.

Re: Some private equity firms are furious over a paper in a dermatology journal

#133

Post by rayiner »

jacquesm wrote: post #105
rayiner wrote: post #104

Earlier quoted context omitted.

The lawyers work for the clients, which in this case are other doctors.

That is not an accurate description of the situation as far as I can see it. The one group of doctors is a bunch of researchers, the other group is a large corporate entity that makes gobs of money from certain products.

> Dr. Matt Leavitt heads Advanced Dermatology and Cosmetic Surgery, the largest dermatology practice in the United States, which is backed by private equity. It is one of the practices that objected to the article.

Re: Some private equity firms are furious over a paper in a dermatology journal

#134

Post by angrow »

maehwasu wrote: post #78
fjsolwmv wrote: post #58

Earlier quoted context omitted.

He had a long and successful career under the patronage of eugenicists and scientific racists who hung on to obsolete ideas after their time had past.

I'm not sure that knee-jerkingly smearing him (by association) as a racist eugenicist quite disproves the point that tenure is not protection from misguided attacks.

No need to turn to his associations for evidence, you're free to read his work and judge for yourself.

Re: Some private equity firms are furious over a paper in a dermatology journal

#135

Post by sizzle »

maxxxxx wrote: post #115
lordnacho wrote: post #44

It sounds to me that what is being monetized is the authority of doctors. There's a lot of medical conditions where you rely on the doctor to tell you what to do. After all, you don't have a degree in that. Now I can buy a clinic and pressure all the doctors through an incentive scheme that they are not used to, and get them all to nudge the borderline cases into must-act cases. And chances are each individual case i…

That's one thing I noticed at my dentist years ago. It used to be a family practice but then they sold to a larger company. From then on every time I was there they tried to push another expensive treatment in addition to regular teeth cleaning. I am not an expert so how could I judge this recommendation? Maybe it's in my best interest or maybe they just want to make more money. Eventually I just stopped going there…

Yup same here, they had a rotating team of dentists who swapped seats every week and often times tried to upsell me on procedures and one had the audacity to joke I was costing them money cause I had no cavities or work needed "it's good for you, not good for me" said with a chuckle, while I rolled my eyes and got the hell out of there eventually finding a family practice I could trust.

Re: Some private equity firms are furious over a paper in a dermatology journal

#136

Post by darkerside »

calgoo wrote: post #45

So I wonder if there is an opportunity to create a service that let's you look up the center you are visiting, and seeing who the investors/ owners are. Then you can filter away any that has gotten bad stars/reviews based on bad practices. Fight vc money with vc money basically.

You'll have a huge problem with uninformed reviewers. It usually doesn't become apparent you've been receiving substandard care (or over care) for quite a while, if ever. Maybe you could contact this by taking reviews only from patient advocates?

Re: Some private equity firms are furious over a paper in a dermatology journal

#137

Post by eesmith »

mikeash wrote: post #132
eesmith wrote: post #123

Earlier quoted context omitted.

So for consistency's sake it's better to just always list allergens, rather than have the regulations say "except when it's bizarre and nonsensical." Otherwise, someone has to decide where that boundary is.

I don’t think it’s really that hard to draw the line. You can still err heavily on the side of safety while not requiring a bag of nuts to warn about the nuts it contains. But our legal system doesn’t go for that sort of nuance.

Why not have a warning label? It's, what, perhaps 4 words extra?

How do you draw the line? Is the exception "if the item is exactly X and labeled exactly X then it doesn't need to contain an allergen notice for X"?

Or is it any broader? What specific knowledge should we assume that everyone knows?

If someone sees the name "milk", should they assume the product contains dairy? What about soy milk? What about peanut butter or coconut cream - do they contain dairy? Does Grape-Nuts contain grapes or nuts?

You might say that all of those should be obvious. But why make that assumption at all?

Isn't it easier to say that all products containing one or more of a given set of allergens must list those allergens? Because that's a really easy line to draw. It's clear to the producer, clear to the consumer, and clear to the legal system.

Re: Some private equity firms are furious over a paper in a dermatology journal

#138

Post by sizzle »

ReallyAnonymous wrote: post #63
copper_think wrote: post #11

What is the value that private equity and/or VC are adding to dermatology? I guess what I'm asking is, why would the physicians be interested in sharing some portion of their income with these non-physicians? Medicine, like other guild professions like law, dentistry, and accounting, is an enterprise which seems to naturally fit the partnership model instead.

I am a general surgeon employed by a hospital system in the southeast. PE / VC don't add anything other than trying to skim a profit off the top of medicine, like any other capitalist. Dermatology is a lucrative practice. They don't have to work in hospitals, so they set their own hours. VC/PE's are doing the long game - purchase a practice (dermatology / anesthesiology, orthopedics ) and reward the current partners…

So is it usually the case that whenever you see a group run medical practice, in comparison to a solo practice, that the facilities are managed by some sort of larger VC/PE group, assuming they are a private,for-profit organization rather than a hospital owned by the city or local university?

The business side of healthcare is fascinating and somewhat terrifying once you follow the money and see how this correlates to positive patient outcomes. I hope more researchers are willing to study this phenomenon without fear of losing career prospects.

Re: Some private equity firms are furious over a paper in a dermatology journal

#139

Post by ItsMe000001 »

rayiner wrote: post #133
jacquesm wrote: post #105

Earlier quoted context omitted.

That is not an accurate description of the situation as far as I can see it. The one group of doctors is a bunch of researchers, the other group is a large corporate entity that makes gobs of money from certain products.

> Dr. Matt Leavitt heads Advanced Dermatology and Cosmetic Surgery, the largest dermatology practice in the United States, which is backed by private equity. It is one of the practices that objected to the article.

It is the head of a private equity backed business. That he also happens to be a dermatologist is not the key - unless you think he would have complained if he were only a dermatologist and not a big-business owner?

From the NY article:

> Eight days later, after an outcry from private equity executives and dermatologists associated with private equity firms

So the complained is from business people. If any of them also happens to be a dermatologist that does not seem to be the key, they don't complain about anything medical. That's because the paper was

> a research paper on its website that analyzed the effects of a business trend roiling the field of dermatology

It was about business, not about medical issues.

I recommend you read the NY Times article.

Re: Some private equity firms are furious over a paper in a dermatology journal

#140

Post by thaumasiotes »

ErikVandeWater wrote: post #129
thaumasiotes wrote: post #40

Earlier quoted context omitted.

I mean, this is close to being right, but it's wrong in every one of the details. Crassus didn't own the fire department. Crassus owned a bunch of slaves who he had trained to put out fires. Crassus didn't charge for extinguishing fires. If your house was on fire, Crassus took his team and negotiated to buy your house . If you sold it to him, he'd put out the fire. There was no flow of money from you to Crassus under…

> Crassus didn't own the fire department. Crassus owned a bunch of slaves who he had trained to put out fires. That sounds like he literally owned the fire department? It was just made up of slaves. Otherwise I really found what you said very interesting!

A fire department is a service that will put out fires for the public.

Crassus only put out fires on his own property. Rome didn't have a fire department. Firefighting was expected to occur on a volunteer, as-needed basis.

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