A conversation between Meredith Hirsh and Anna Sobkiv (J.P. Morgan) explores how private equity is rapidly shaping physician practices—driving growth, acquisitions, and succession planning. The discussion highlights why investor interest is accelerating, which specialties are attracting capital, and what these deals mean for ownership, autonomy, and long-term sustainability of independent medicine. The signal: Private equity is no longer optional—it’s becoming a defining force in how physician practices grow, transition, and remain viable.
Author: Abhay Panchal
A recent JAMA viewpoint reframes the AI debate in medicine: the real disruption isn’t that AI is becoming more human—it’s that medicine has become less human over time. Despite headlines suggesting AI is surpassing physicians in empathy, the reality is more uncomfortable. Clinicians haven’t been outperformed at the bedside—they’ve been pulled away from it. Over decades, administrative layers—documentation, billing, prior authorization, and EHR work—have gradually displaced physicians from direct patient care, leaving less time for the human elements of medicine. In some settings, physicians now spend nearly twice as much time on desk work as with patients.
A new report from the American Medical Association shows physician burnout is gradually declining, with gains in job satisfaction and retention. But the bigger shift is structural: burnout is becoming highly specialty-specific, not universal. Gastroenterology lands squarely in the middle of this spectrum—at ~43.5% burnout—below peak-stress fields like emergency medicine, but still firmly in the high operational burden tier alongside cardiology and general surgery. This positioning matters. GI isn’t in crisis, but it’s also far from insulated. The drivers remain consistent across specialties: EHR friction, staffing shortages, and administrative overload. In GI, these are amplified by a unique combination of…
A key shift is emerging in physician practice strategy: independence is no longer about staying small—it’s about getting big enough to survive. Rising administrative complexity, staffing costs, and payer pressure are pushing smaller practices toward a structural disadvantage. The reality is stark—groups below ~40–50 providers often lack the infrastructure (leadership, contracting leverage, data systems) needed to operate sustainably, forcing them to consider mergers, partnerships, or external capital. At the same time, many physicians misunderstand what their practice is actually worth. Valuation isn’t based on total income—it’s based on “replaceable cash flow,” typically ~30% of physician earnings, meaning selling a practice…
GLP-1’s drugs continue to expand horizons in gastroenterology, bariatrics, diabetes and chronic disease care — but the scale of the drugs’ adoption could be creating new areas of risk management for physicians, according to a report published Risk & Insurance April 29.The first wave of concern relates to the proliferation of compounded medications and counterfeit products, according to the report. The FDA has raised concerns about unauthorized and improperly compounded GLP-1 formulations that may contain incorrect dosages or ingreidnets.
A study published in Clinical Gastroenterology and Hepatology highlights findings from the first-ever in-human trial using a special real-time artificial intelligence system to diagnose cancer in the digestive system. Led by Neil Marya, MD, assistant professor of medicine, director of the Program in Digital Medicine, and director of the Digital Medicine Fellowship at UMass Chan Medical School, the SMART-AI trial showed that using AI was better at diagnosing cholangiocarcinoma, or bile duct cancer, than a biopsy.
An investigational procedure—duodenal mucosal resurfacing (DMR)—is emerging as a potential solution to one of the biggest challenges in obesity care: what happens after GLP-1s are stopped. In a randomized, sham-controlled trial, patients who discontinued GLP-1 therapy typically regained weight—but those who underwent DMR maintained the majority of their weight loss, with significantly less rebound at six months. The procedure works by ablating the duodenal mucosa, targeting a region increasingly recognized as central to metabolic regulation. This directly addresses a growing real-world problem: while GLP-1 drugs are highly effective, 60–70% of patients discontinue them within a year due to cost, side…
Virgo Surgical Video Solutions’s collaboration with the Rajpurkar Lab marks a significant shift in how AI will be built for gastroenterology—not as isolated algorithms, but as foundation models trained on massive, multimodal datasets. At the core of this effort is scale: Virgo is contributing over one million endoscopy videos (within a dataset of millions of procedures), enabling the development of models that go beyond narrow tasks like polyp detection. The goal is to create systems capable of disease detection, risk scoring, treatment prediction, and outcome forecasting—all from routine endoscopic procedures. What’s particularly important is the move from frame-based AI to…
A large population-based study shows a stark reality: colorectal cancer (CRC) risk isn’t just about screening—it’s about completion of the screening pathway. Among individuals with a positive stool test (FOBT), those who did not undergo follow-up colonoscopy had ~4x higher CRC incidence, while those who completed colonoscopy—especially with negative findings—had lower-than-average cancer risk. This flips the usual narrative: the initial test is only as valuable as the system that ensures follow-through. What’s particularly notable is the role of quality and system design. In this Swedish program, high colonoscopy completion rates (~87%) and strict quality standards for endoscopists contributed to better…
mbiomics’s €30M Series A marks a key transition point for the microbiome space—from promising biology to clinical and manufacturing execution. The company is building Live Biotherapeutic Products (LBPs)—oral therapies made from defined combinations of live bacteria—designed to restore microbiome function in a controlled, pharmaceutical-grade format. This directly addresses one of the field’s biggest bottlenecks: while approaches like fecal microbiota transplantation (FMT) have shown efficacy, they remain variable, non-standardized, and difficult to scale.What differentiates mbiomics is its full-stack platform approach—combining AI-driven design of microbial consortia, proprietary analytics, co-cultivation, and manufacturing capabilities. This allows them to move beyond trial-and-error biology toward engineered,…