Only 14% of physicians say private equity involvement is good for the future of health care. That figure comes from the Physicians Foundation's 2024 survey of more than 1,700 physicians, and it belongs next to a second number from the same body of research. In a JAMA Internal Medicine analysis published in early 2025, physicians employed by private-equity-owned practices reported job satisfaction of 44.8%, against 74.4% for physicians who were not. Autonomy followed the identical pattern, 48.3% versus 66.3%. The doctors inside these arrangements are reporting, in survey after survey, that the experience is markedly worse than the alternative.

Read those numbers together and a particular weight should lift off your shoulders. If you looked at private equity in ophthalmology and felt a pull to stay away, you weren't being timid, naive, or insufficiently ambitious. You were reading the situation accurately. The physicians actually living inside those platforms are telling you, with their own reported satisfaction, that the thing you were wary of is roughly as bad as you suspected it might be.

You Were Right, Not Risk-Averse

There's a story that gets told about younger physicians, that they avoid ownership and avoid risk because they want an easy path, because they lack the appetite their predecessors supposedly had. A recruiter who has spent two decades placing ophthalmologists put a sharper point on it in a recent conversation: these doctors watched what happened to the generation just ahead of them, and they made a rational choice to protect themselves. That isn't laziness. That's pattern recognition operating exactly as it should.

The pattern they recognized is the one the survey data confirms in cold numbers. They saw practices sold to private equity, watched colleagues lose clinical authority, watched promised payouts stall behind liquidity events that never arrived, and concluded that the safe move was to steer clear of the whole arrangement. That conclusion was correct as far as it went. The single thing it missed is that avoiding private equity and avoiding ownership are two different decisions that got collapsed into one. The fear was accurate about private equity, then quietly stretched to cover all of ownership, and that stretch is the precise point where an accurate, protective instinct hardened into a cage.

The Sleight of Hand, Step by Step

This is the maneuver worth watching in slow motion, because it's how a justified wariness gets weaponized against the person who holds it. First, a young ophthalmologist develops a well-founded wariness of private equity, grounded in real observation and now backed by real data. That wariness is protective and correct. Second, the available options get presented as a short, fixed menu: take the private equity job, take the hospital job, or take on a crushing debt load to build a solo practice from nothing. Third, with ownership represented on that menu only by its hardest and most frightening version, the wary doctor reasonably selects salaried employment and files it under "the safe choice."

But the menu was rigged by omission. Ownership of an established practice, with the acquisition funded so the physician carries no debt and the operational burden handled by a management company, was never placed on the menu the doctor was shown. The wariness about private equity, entirely justified, got used as the lever to push the physician away from a form of ownership that contains none of the features that made private equity worth being wary of in the first place. The fear was real and well-earned. It was simply aimed at the wrong target by people who benefited from the misdirection.

Why the Dissatisfaction Runs So Deep

It helps to understand why the satisfaction numbers inside private equity are so low, because the specific reasons map directly onto what a different ownership structure can avoid. Physicians in private equity arrangements report losing meaningful control over clinical decisions, facing volume expectations dressed up in the language of alignment, and watching equity they were promised stay locked behind a liquidity event that may never arrive on any timeline they can plan around. The dissatisfaction is structural rather than incidental. It flows from the concrete mechanics of how private equity owns and runs a practice, not from the general experience of being part of something larger than a one-doctor office.

Change the mechanics and the dissatisfaction loses its anchor points one by one. A structure in which the physician owns the clinical entity outright, holds clinical authority in writing, faces no volume quota, and isn't waiting on someone else's exit to realize the value of their own work removes precisely the features the survey respondents are unhappy about. The 14% figure reflects how doctors feel about the particular bargain private equity offers, which is a far narrower thing than how they feel about belonging to any organization larger than themselves. Only one of those is structurally unavoidable, and it isn't the one a permanent-hold model contains.

Naming the Guilt and Setting It Down

There's an emotional residue worth addressing directly, because it shapes behavior even when it goes unspoken. Many physicians who chose the salaried path carry a low, persistent guilt about it, a sense that they weren't the kind of doctor brave enough to take the ownership leap, that they settled. The survey data is permission to put that guilt down. Your instinct was sound. The thing you avoided is, by the direct testimony of the 86% of physicians who think private equity is bad for medicine and the colleagues reporting 45% satisfaction inside it, genuinely worth avoiding. What got taken from you was never your courage. It was an accurate picture of the one option that would've let you own something real without signing up for the arrangement your peers are warning you about.

Verdira was built around the features that make private equity arrangements miserable, and around removing each of them deliberately. The physician owns the professional corporation. Clinical decisions stay with the physician, set down in writing before anyone signs anything. There's no volume quota anywhere in the model. And there's no exit clock, because the platform is built to hold practices rather than to flip them, which means no physician is left waiting on a sale that determines whether their work ever pays off. The 14% number is the problem laid bare. A structure engineered to eliminate the reasons behind that number is the answer, and it's the one your accurate, hard-earned wariness was pointing you toward all along, even when the menu in front of you hid it from view.

This article is for general educational purposes and isn't financial advice.

Verdira is a healthcare acquisition platform focused on ophthalmology practices. Physician ownership. Transparent structure. No volume quotas. If you're a physician exploring ownership, we're open to thoughtful conversations. Contact info@verdira.com | 307-381-3734 | verdira.com Images are AI-generated illustrations and do not depict actual Verdira practices, physicians, or patients.