Any time I am faced with this kind of shocking inefficiency, I ask myself a simple question: why was no one doing this before?
Well, as I understand it, the general belief is that...
The “scaled up” practices are relatively unpleasant to work in, and make people (who went through a lot of education expecting to get “prestige” jobs, mind you...) feel deprived of agency, deprived of choices about the when-where-and-how of their work, and just generally devalued.
The “non business savvy” people who actually generate the value believe, probably entirely correctly, that somewhere between most and actually-more-than-all of the increased income from that kind of scale-up will end up going to MBAs (or to the one or two theoretically-practitioners who actually own of a “medium-sized” practice), and not to them[1].
Healthcare facilities operated by private equity are widely believed, both based on industry rumor and based on actual measurement, to reduce quality of care, and people don’t like to be forced to do a bad job if they don’t have to?
Why would you voluntarily make your daily life actually unpleasant just to increase an already high income that you’ll probably have less time to enjoy anyway?
… and it may not drive prices down for the consumer as much as you might think, either, because many consumers have limited price sensitivity as well as very limited ability to evaluate the quality of care.
“Why would you voluntarily make your daily life actually unpleasant just to increase an already high income that you’ll probably have less time to enjoy anyway?”
IIRC, dentists have some of the highest rates of depression and suicide of any profession. As for if this means things could only get better under a new business model, increased earnings would translate to earlier retirements (and by extension lower supply of labor), or if dentists would prefer to keep their current earnings over trying a potentially more intensive job, I can’t say.
Well, as I understand it, the general belief is that...
The “scaled up” practices are relatively unpleasant to work in, and make people (who went through a lot of education expecting to get “prestige” jobs, mind you...) feel deprived of agency, deprived of choices about the when-where-and-how of their work, and just generally devalued.
The “non business savvy” people who actually generate the value believe, probably entirely correctly, that somewhere between most and actually-more-than-all of the increased income from that kind of scale-up will end up going to MBAs (or to the one or two theoretically-practitioners who actually own of a “medium-sized” practice), and not to them[1].
Healthcare facilities operated by private equity are widely believed, both based on industry rumor and based on actual measurement, to reduce quality of care, and people don’t like to be forced to do a bad job if they don’t have to?
Why would you voluntarily make your daily life actually unpleasant just to increase an already high income that you’ll probably have less time to enjoy anyway?
… and it may not drive prices down for the consumer as much as you might think, either, because many consumers have limited price sensitivity as well as very limited ability to evaluate the quality of care.
“Why would you voluntarily make your daily life actually unpleasant just to increase an already high income that you’ll probably have less time to enjoy anyway?”
IIRC, dentists have some of the highest rates of depression and suicide of any profession. As for if this means things could only get better under a new business model, increased earnings would translate to earlier retirements (and by extension lower supply of labor), or if dentists would prefer to keep their current earnings over trying a potentially more intensive job, I can’t say.
I’m pretty sure that this is incorrect compared to healthcare more broadly, although the best I can come up with is this meta-analysis: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226361&type=printable
Which has this to say:
[The Simpsons] “I’m Not Made of Stone !”, Says Krusty the Clown