Many physician leaders are reporting a troubling pattern: Physicians who sell their practices to private equity, cash out and then end up recreating the same predatory terms on the physicians coming up behind them.
Private equity consolidation is reshaping medicine at scale. Nearly 10% of U.S. gastroenterologists are part of PE-backed practices, according to a 2023 study published in Gastroenterology & Hepatology. Private equity firms were involved in nearly 300 physician medical group transactions in 2024, according to VMG Health’s 2025 M&A report.
Amid that wave of consolidation, one physician says the bigger risk to junior physicians isn’t the deal itself, but rather the senior physicians who broker it.
Rajiv Sharma, MD, a gastroenterologist and president of Phoenix-based Mirage Health, told Becker’s that many private equity-backed physician groups follow a familiar arc: A senior physician sells the practice, joins the PE-backed board and ends up imposing the same disadvantageous terms on the physicians coming up behind him.
“First they were just another physician, and suddenly they’ve got PE money behind them, and it makes them feel good, and they’re the oppressors,” Dr. Sharma said. “That’s worse to me.”
He said the pattern amounts to senior physicians cashing out for personal payouts — he put the figures in the seven and eight figures — while pushing the resulting debt and diminished terms onto junior partners and future partners.
“It is a moral obligation of senior physicians to protect the younger ones,” Dr. Sharma said.
The dynamic extends beyond compensation. When the founding physicians who built a practice are replaced by non-physician administrators empowered by PE backing, the effect on those below them is corrosive, he said.
“When a physician has to report to a non-physician, it is an absolute insult at the DNA level,” he said.
It’s also why he said he ultimately went independent.
“That’s the reason right now I’m solo, and I’m an entrepreneur,” Dr. Sharma said, adding that he didn’t want to be taken advantage of by physicians who, once aligned with private equity, stop advocating for the physicians under them.
The pattern is not limited to GI.
“The main complaint from physicians is that by selling to an entity, they lose control of their practice,” Evan Pollack, MD, an internist in West Chester, Pa., told Becker’s.
Physicians lose control over key aspects of their work — the number of patients they see each day, what they can order and how they can structure their schedules. Nearly 78% of physicians believe PE investment could compromise patient care, according to a 2026 Sermo poll.
Left unaddressed, Dr. Sharma said the consequences reach beyond any individual practice.
“What we’re gonna have is: No. 1, we’re going to have lawsuits. No. 2, we’re going to have the physician profession corroding and eroding. Nobody wants to be in that profession, and we’re going to have a wave of physician burnout,” he said.
He added that physicians who cannot earn a living properly because of a bad contract experience it as deeply demoralizing, and that many simply trade one imbalanced relationship for another by becoming hospital employees. He described the position many physicians are in as being “stuck between a cactus and a barbed wire.”
Dr. Sharma argued that many private equity buyers simply don’t understand physician workflow well enough to know they’re causing harm, although he said the effect is the same either way.
“For most private equity firms, buying a physician practice is no different to them than buying a condo,” he said. “Sadly, physicians and the patients happen to be in the condo.”
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