Recently I came across an article about a group of emergency medicine doctors and consumer advocates that were trying to push back on the trend of private equity in our emergency rooms. Large equity funds are buying up medical groups – and particularly medical groups providing care in emergency departments – “corporatizing” the practice of medicine.

As the story goes, in the early 1900s several laws were created to protect the practice of medicine. These included laws that only allowed medical groups to be owned by licensed doctors (and not corporations).

Over the course of the next many decades, these protections have been eroded (or ignored). And, not unlike many areas of our society, corporations have made inroads in the ownership, and profitability, of health care.

We are not talking about just a few emergency rooms here or there, but as many as 25% of all of the nations ERs are staffed by companies backed by private equity. That is entities with one goal: profit. One of these staffing companies – TeamHealth – has a significant footprint in Washington State, including (but not limited to) locations in Spokane, Bellingham, the Tri-Cities, Centralia, and Ellensburg.

The consumer advocacy group is hoping that a currently contemplated lawsuit (to be filed in 2024) will push back on this trend, and perhaps return medicine in the United States to a place less purely driven by profit.

With corporate entities such as Blackstone (which owns TeamHealth) out of health care, and a return to doctors owning medical group, proponents of the lawsuit say that doctors will have more independence to treat their patients, including more time to do so. Now, the practice of medicine for a corporate employer includes an emphasis on speed (more patients = more $$), using cheaper (and less qualified) providers, and the use of one-size-fits-all protocols that is inconsistent with providing good medical care.

However, skeptics think there is no going back to some mythologized golden era of medical care. Corporations and hospitals now employ nearly 7 in 10 doctors in the United States. And there are plenty of positives to medical care when corporations are in charge, including efficiency! Growing new markets! And integrating new technologies!

From the perspective of a medical malpractice lawyer, I see positives and negatives from the increasing involvement of corporate interests in the delivery of health care in our society.

Certainly, there is a reasonable argument to be made that capitalism and corporations can spur technological advancement, including new medications and treatments that will likely improve the lives of millions and millions of Americans.

And also, it is a common refrain from patients these days that doctors don’t have time for them anymore. People – not just the patients but often the doctors themselves – feel rushed during hospital visits. This lack of time with patients has, does, and will result in delays and failures to diagnose conditions.

Alternatively, corporations have a built-in profit motive. Presumably, then, they’d prefer that their doctors provide care that does not result in malpractice claims they will likely have to pay (through their professional malpractice insurance policies). This might result in a more standardized way of doing things. On one hand, the article points out that a particular protocol might not fit everyone, and might do more harm than good.

On the other, I’ve seen plenty of instances where an emergency room doctor relied on his or her “clinical judgment” in ruling out a deadly condition, when the patient in fact had it. And had the doctor used one of a number of handy, simple, evidence based tools, she would have realized it would be smarter (and safer) to run a simple screening test just to make sure.

I can’t imagine this or any other lawsuit is going to stop the inevitable progression to a more corporate, privatized, and monetized health care system. There’s too much money to be made. Perhaps the technological advancements will outweigh the harm to patients of this “progress”.

Only time will tell.