Gordon Gekko, the brilliant but ruthless corporate titan at the center of Oliver Stone's 1987 film “Wall Street,” was a private equity investor, whose tactics earned him millions in the cutthroat world of mergers and acquisitions. The classic quote was “Greed is Good!” But is it? The answer matters because private equity ownership of anesthesia groups has been a reality for decades, with increasing prominence in recent years.

A recent editorial in the New England Journal of Medicine discussed the expanding role of private equity in acquiring physician practices (N Engl J Med 2021;384:981-3). Private equity (PE) firms use capital sourced from pension funds, sovereign wealth funds, high net-worth individuals, and endowments to invest in promising businesses. PE investors typically seek a return of at least 20% to offset the risks involved, as future growth cannot be...

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