Urologists: What Hospitals and Private Equity Don’t Want You To Know


You entered the field to make a positive impact on people’s lives and to have a fulfilling career. 

However, many hospitals and private equity firms prioritize profits over the values that you hold dear. They often focus on maximizing revenue, which can lead to high levels of burnout and a lack of autonomy.

Independent practices, on the other hand, offer a different path for you to achieve your professional goals and align your values with your work.

By choosing an independent practice, you can regain control of your career and make a difference in the lives of your patients by providing high-quality patient care, free from the constraints of a corporate-driven healthcare system.

Here is what Hospitals and Private Equity don’t want you to know:

Revenue is Everything

The entire goal of private equity is to buy a practice, make it more profitable, and sell it for a profit. PE firms have a responsibility to their investors to maximize profit. Too often it’s at the expense of good patient care. Being a doctor is hard enough without the increased financial pressure of investors and corporate executives. Great doctors don’t put profit over patient care.

Burnout is High

Multiple recent studies, including those published by the Mayo Clinic, found that burnout is higher in hospital-owned practices compared to private practices. Researchers found that hospital-employed physicians were more likely to experience emotional exhaustion and depersonalization — two key indicators of burnout.

You’ll Make Less Money

Money isn’t everything – but it’s important when you’re staring down student loans. Sure, some hospitals can promise high salaries for new doctors, but you’ll make more over your career in independent practices.

Once you’re an owner/partner (usually two to five years) your earning potential dramatically increases because profit is shared exclusively with physician partners — not with investment managers or hospital executives.

Most independent practices have profitable ancillary services that increase partner compensation even more. The highest-paid urologists are found in independent practices.

Say Goodbye to Autonomy

Want to make a decision that aligns with your values and priorities? Think again. Decisions about the practice’s direction and priorities are made by outside investors and corporate executives rather than the physicians themselves.

Physicians with low autonomy are much more likely to experience burnout, job dissatisfaction, and low engagement.

Patient Outcomes Are Worse

According to a 2019 study on urology practices, patients who received care from independent practices had lower rates of hospitalization, fewer emergency visits, and lower total healthcare costs compared to patients who received care from hospital-owned practices.

Get used to a Lumbering Bureaucracy

Hospital-owned practices have more bureaucracy and administrative red tape, which can result in more time spent on non-clinical tasks and less time spent on patient care.

Work/Life Balance Is Not A Priority

Hospital-owned or private equity-backed practices usually have more rigid schedules and less flexibility, which can negatively impact your work-life balance. Investors are never going to put your work-life balance ahead of their financial returns.

The Culture Stinks

In large systems, it’s hard to develop a strong, positive, and supportive culture. New policies, procedures, and an ever-changing physician workforce make it difficult to collaborate and grow.

Fewer Sub-Specialty Opportunities

Sub-specializing can enhance your reputation and career, improve patient outcomes, and satisfy your personal interests while keeping you engaged with work.

The lack of these opportunities in non-independent groups means less career advancement, lower job satisfaction, and decreased earning potential.

The opportunity to sub-specialize is seen by some physicians as a key factor in their career satisfaction and success.

Independent Practices are Hiring

There are opportunities throughout the country to work at truly independent urology practices.

Get A Free Mentoring Call

Lots of young urologists, especially those in residency, have questions about their options. Schedule a call with one of our experts:

Tamra Lewis, MD – Urologist and Managing Partner

  • Patient Care in Private Practice & Work/Life Balance
  • Leadership & Professional Development
  • Practice Ownership

Dan Schonwald – Urology Practice Administrator & Healthcare Veteran

  • Contract Negotiation Tips
  • Compensation Rates
  • Business of Urology