Incorporating Healthcare: What Would Osler Say?

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Disclosure: Mr. Calabrese reports professional relationships with AbbVie, AstraZeneca, Bristol-Myers Squibb, Galvani, Genentech, GlaxoSmithKline, Janssen, Novartis, Regeneron, Sanofi and UCB.

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“Medical practice is an art, not a profession. It is a vocation, not a job. – Sir William Osler, MD, FRS, FRCP

First of all, I would like to thank all the debaters who participated in this month’s cover story. Stanley B. Cohen, MD; Madeleine A. Feldman, MD; FACR; and Dr. Michael C. Schweitz — To give a fair and balanced treatment to the realities surrounding private equity incursions into the rheumatism sector.

Images that depict the world of private equity and healthcare

Image: Adobe Stock

They clearly present the advantages, and at least in my naive view of such trades, for those who put a lot of effort into building a successful practice and have the equity to sell it. profit. Who can deny their rights? However, after the clinic was sold, this new organization sought to develop patient care in a way that fulfilled its aspirations for what health care was and should be, and at the same time, what it would achieve. It is no longer run by beleaguered physicians who entered the medical world to treat. good life. The new boss is a legal entity whose mission is to derive maximum benefit from the new arrangement.

Leonard H. Calabrese, DO
Leonard H. Calabres

I am well aware that many of these large companies have many physicians involved in their management and ideal security measures are in place to protect and serve patients and recruits. . But after all, the main mission of the new organization is profitability. The question arose in my mind, what would the great Sir William Osler say?

After all, we all took the oath when we graduated from medical school. We didn’t just promise, “Don’t worry, we’ll take out tonight.” An oath is an affirmation, a solemn promise that we make. We are no longer talking about the neo-modern Hippocratic Oath, but there are more modern versions, such as those created by medical humanists. Dr. Louis Lasagna, In that version, we pledge our very existence to the sick, recognizing our “special obligation” to them and to society. It also speaks of warmth and sympathy, but does not prohibit profit.

Overall, I’d say most private equity firms aren’t keen on brandishing this pledge as a corporate “mission statement.”

Mr Osler said: “The practice of medicine is not and will never be a business,” and “the human mind in which we live must control our professional relationships.” Let me tell you, Osler wasn’t immune to criticism in that he made a lot of money from practicing, publishing, etc., as many of us do now. But I would be very surprised if Sir William sold the Johns Hopkins clinic to a private equity firm and became an employee of that firm.

As you can see, I’m not a fan of such deals, but I’m also not in a position to profit if my clinic is sold anyway. To be fair, if I had a large stake in a self-built clinic and wanted to support my retirement, I might think differently. I can’t answer this for sure, but I hope not. That being said, I am sure some will find my musings on the subject overly romanticized, out of a yearning for arts and practices that no longer exist here.

I hear you, but for many of us, patient care days range from average to pretty good to bad in my world. Some days can seem very unfair to caregivers and patients. . However, when we work together to handle complex cases, when we engage in inspiring educational moments with those who follow us, or simply when we truly share our humanity with others. There are still other days, such as when you are privileged to do so. , it still feels magical to me.

That’s my take. you? Please send any comments to or

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