As gastroenterologists, we’re all experiencing the effects of a growing physician shortage. From increased workloads to recruitment challenges and burnout, it’s a multifaceted issue and one I believe deserves candid discussion, especially as more GI groups explore private equity (PE) partnerships.
Having worked within a PE-affiliated practice for nearly five years, I’ve observed that PE can offer structural support and resources that may help address some challenges facing our profession, if approached with care and appropriate oversight.
One of the most immediate benefits PE brings is access to capital. That capital allows us to expand services, upgrade facilities and technology, and strengthen our operational infrastructure. These investments help create a more efficient, patient-centered practice, one where physicians can focus more on medicine and less on administrative burdens.
Of course, capital alone isn’t a solution. A more important question is whether PE partnerships actually enhance physician satisfaction and retention. In my experience, they can. Hospital-affiliated practices often struggle with high turnover, whereas PE-backed groups tend to see more stability. When physicians feel supported, respected, and valued, they’re more likely to stay, and that speaks volumes.
Still, I won’t pretend the concerns around PE aren’t valid. There’s plenty of conversation about autonomy, profit pressures, short-term focus, and conflicts between clinical and corporate priorities. I take those seriously, but I also believe they can be addressed with the right approach.
Before joining any PE group, GI practices need strong legal and financial representation. You need to understand how your practice is valued, what changes will come to compensation, and how clinical autonomy will be protected. Ask hard questions: Will we have a seat at the table? What’s the exit strategy if it’s not the right fit? What happens to our staff?
In my experience, clinical decision-making has remained largely within the hands of physicians. While business operations such as staffing are subject to administrative input, I’ve generally found that clinical autonomy is respected.
This approach also applies to staffing models and service integration, such as telehealth. Decisions are typically made in alignment with clinical needs rather than imposed directives.
Private equity could have an even greater impact on physicians just entering the field. Many early-career GIs are understandably uncertain, often assuming that PE ownership means sacrificing autonomy. However, what’s frequently overlooked is the potential for shared ownership and added support. When the model is clearly explained, many begin to recognize the benefits.
That said, PE isn’t for everyone. If complete independence is your top priority, solo practice may be more appealing, but it’s a model that’s becoming harder to sustain. In many PE-affiliated groups, physician leadership has been retained, practice stability ensured, and work-life balance improved.
Of course, we have to stay attentive to market dynamics and evolving regulations. Private equity involvement in healthcare is subject to shifting policy landscapes and financial pressures, so it’s critical for any group to fully understand the long-term vision of their PE partner. Alignment on strategy, clinical values, and sustainable growth should be non-negotiable.
If you’re considering a PE partnership, go in with your eyes wide open. Do your homework. Surround yourself with strong advisors. But most importantly, stay grounded in the values that brought you to this profession: passion for the work, a commitment to quality, and integrity in every decision.
If you bring those into any model, PE or otherwise, you won’t just adapt. You’ll thrive.
Harish Gagneja, MD, FASGE, is a gastroenterologist with Austin Gastroenterology, a GI Alliance practice.