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🎯 Why Listen

What happens when private equity buys hospitals? Do staffing cuts and profit motives compromise patient safety? This episode of The Doctor’s Lounge dives into the controversial world of private equity in healthcare, the role of RVUs and the RUC, and why physicians are losing control over their profession. Expect an unfiltered discussion on power, profit, and the future of independent practice.

👥 Co-Hosts

• Dutch Rojas – Founder, Bliksem Health
• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice
• Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur

📌 Episode Overview

This conversation unpacks:

• The hidden mechanics of RVUs and the RUC committee (and why most doctors don’t know how their pay is set).
• How private equity staffing cuts may be tied to increased ER deaths.
• Why physicians are forced to “take shelter” with private equity or large health systems.
• The structural inequities in U.S. healthcare that tilt the system against independent doctors.
• The hope found in physician-owned hospitals and physician-led enterprises.

💬 Notable Quotes

• “Just because you have a higher RVU count does not mean you’re a better physician.” – Dr. Dan Choi  
• “The real problem isn’t that the RUC exists—it’s that CMS has built an entire system on centrally planned values.” – Dr. Anthony DiGiorgio  
• “When private equity is the boss, the boss isn’t a physician—it’s a portfolio manager.” – Dr. Dan Choi  
• “We went from 75% independent practice to 12%. That’s the legacy of partnerships that never built enterprise value.” – Dutch Rojas  
• “You don’t need to import H1Bs or expand scope. You need to let physicians own hospitals in their own communities.” – Dr. Anthony DiGiorgio  

📚 What You’ll Learn

• How RVUs and the RUC committee determine physician pay.
• The risks and trade-offs when hospitals are acquired by private equity.
• Why many “boomer doctors” cashed out, leaving younger physicians holding the bag.
• The differences between profit-driven care and physician-led models.
• Why physician-owned hospitals may be a solution to America’s healthcare crisis.

⏱ The Episode (Timestamps)

00:00 – The growing demand for private practice

02:00 – Private equity: efficiency or exploitation?

06:00 – Explaining RVUs and the RUC committee

15:00 – Gaming the RVU system & compensation models

20:00 – Myths and realities of the RUC process

22:00 – Harvard study: private equity, staffing cuts & ER deaths

27:00 – Physicians vs. portfolio managers: who should run healthcare?

33:00 – Selling out: boomer doctors and the PE cash-out

37:00 – From 75% independent practice to just 12%

39:00 – Physician-owned hospitals as a solution

43:00 – Can capitalism coexist with morality in medicine?

50:00 – What happens if private equity is banned?

52:00 – The federated model and the fight

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X