Скачать или смотреть Private equity is ruining medical professions as women ascend in them - coincidence?

Private equity (PE) firms have increasingly acquired US hospitals since the early 2000s, often through leveraged buyouts and roll-ups of health systems. While hedge funds are less involved than PE, some (e.g., via REITs) participate in real estate aspects. Acquisitions surged post-2008 financial crisis, with $100 billion invested in 2018 alone—a 20-fold increase from two decades prior. Total PE healthcare investments reached $800 billion over the past decade, with hospitals comprising a key segment. As of March 2025, PE owns ~488 hospitals (out of ~6,100 total), representing ~8% of the market but higher in rural areas (27.7%). Deal volume grew from 352 PE healthcare buys in 2010 to 937 in 2020 ($806 billion total). In 2024, healthcare deals hit $104 billion (second-highest on record), though hospital-specific M&A declined slightly in early 2025 amid economic pressures. Projections: PE activity stable at ~$100-120 billion annually through 2030, with focus on outpatient transitions.

Decline of Independent Physician Employment: From 60% independent in 2012 to 42% in 2024 (18-point drop); only 22% fully independent per some estimates. Hospital-owned: 34.5% (up from 23.4%). Small practices (less than 10 physicians): 47% (down from 61%). Burnout (49% physicians) and shortages (187,000 FTE by 2037) accelerate shift to employed models.

PE entered veterinary aggressively post-2017, investing $51.6 billion (2017-2023) + $9.3 billion early 2024, driven by pet ownership boom (45.5% households with dogs in 2024). Corporate/PE owns 25-30% of practices (up from 8% a decade ago), 35% overall in 2024, and 75% of specialties. Deals: PE drove 60% volume/80% capital in 2024; 120+ add-ons in H1 2025. Valuations: 9-12x EBITDA (up to 15x for high-performers). Market: $69.4 billion revenue (2025, +1.9% CAGR). Projections: 40-50% corporate by 2030; stabilization in 2025 amid selectivity.

Decline of Independent Dentist Employment: From ~93% non-DSO (2015) to 87% (2021); ownership stakes down as employment rises (e.g., via DSOs). Small practices declining; burnout up 15% (to 42% in 2023). Shortages: 10,000 dentists by 2030, favoring corporate models.Overall, PE-driven consolidation has reduced independents across fields (e.g., 18-point drop for physicians), raising costs (vet prices +9.6% YoY 2024) and access concerns, though it provides capital for growth. Healthcare employment grew to 17 million (2023, +10.8% of workforce), but burnout (49% physicians, 45% nurses) and shortages persist.

Private equity remains heavily male-dominated, with gender gaps widening at senior levels due to promotion biases and retention challenges. Data from recent reports (primarily 2023-2025) shows women holding about 22-35% of overall roles, but far less in executive positions. Men are promoted ~50% more often than women in investing roles.

Executive/Leadership (CIOs, Partners) - 87-91%
male

9% median female CIOs across 29 markets; 13.7% key decision-makers. Women: less than 6% in top teams.

% Female Practicing Dentists
Key Notes
1970s
~3-5%
Graduates: ~5% female in 1976; enrollment less than 10%.
1980s
~8-10%
Graduates: 11% in 1978, rising to 22% by 1986.
1990s
~12-15%
Steady increase in female enrollment to ~30-35%.
2000s
~16%
In 2001: 16%; graduates ~40% female by late 2000s.
2010s
~24-30%
In 2010: 24%; first majority-female graduating classes in some schools by 2019.
2020s
~35-39%
In 2020: 35%; in 2024: 39% (nearly 2 in 5 dentists); graduates: 52-56% female.

Veterinary medicine has seen the most dramatic shift, becoming female-dominated by the 2010s due to high female enrollment in vet schools (now ~80-85%). This "feminization" began in the 1970s and accelerated post-1980s. Data from the American Veterinary Medical Association (AVMA) and Association of American Veterinary Medical Colleges (AAVMC).

Enrollement in human medical schools at 54.6% female (2023-24) and expected to continue to rise.