Why You Can’t Afford Your Doctor, Dentist, Veterinarian or Even Dinner at Olive Garden

Inflation isn’t the whole explanation

Photo by Karsten Winegeart on Unsplash

When I was in college and making $3.35 per hour, I was able to pay the full cost of neutering my kitten, Putter. I also paid a dentist to fill a painful cavity around that time. I recall writing checks for both of these things.

A person with very little money could afford things like that then. Now, things have changed. Why? We talk about inflation and lagging pay, but that’s not the whole story.

The vet I went to had her own private practice. It was a little small-town office with a lot of plants. It wasn’t fancy but it was pleasant. I remember it well almost four decades later. I didn’t just pay for Putter to lose his boy bits — I also had to have some of his teeth pulled and he had to start taking pills for his epilepsy. That kitty had issues that I’d struggle to pay for now. But vet care was far more affordable then.

I only saw that dentist one time. There wasn’t money in my budget for regular dental care, but I did need to have that cavity dealt with. I randomly picked a dentist from the yellow pages, got my painful tooth fixed and paid for it myself.

When I went to the doctor as a kid, it was always one doctor with his own office. (Yes, they were always men in those days. I am talking about the past right now. Some things were better and some things were worse.)

But now, when I visit a veterinarian, doctor or dentist, I’m not just paying for their professional services. I also have to help some private equity or hedge fund make an absolute killing.

No more do you go see Dr. Davis when you have a cavity; you go to something like Northside Dental Group, and you might never see the same dentist twice. Thanks, private equity! This piece in The White Coat Investor explains what private equity has done to dentistry. Private equity can extract value from a practice faster than your dentist can yank a wisdom tooth.

You don’t go to Dr. Kim when you get a new kitten; you go to Best Friends Vet Clinic, and you’ll see whatever vet is on duty when you get there. Here in this piece in The Atlantic, you can read how private equity has been gobbling up private veterinary practices the way my dog gobbles up table scraps.

You probably do have a specific doctor, and sometimes you will even see that doctor, if you set up an appointment in advance. But if you get sick, you’ll see whatever doctor or nurse practitioner is there that day. The Hill explains it all in this piece. What private equity does to medical offices is akin to what the proctologist does after telling you to relax.

Opening your own private practice of any kind is expensive and daunting. I can well understand why a recent graduate, already loaded down with student debt, would decide to join a practice rather than renting an office, buying equipment, hiring help and all the rest.

Money trumps professional care now

Everybody has to answer to their corporate overlords. When I have a medical appointment now, I feel like a product being hustled down the assembly line as quickly as possible. It’s been ages since I’ve had a medical visit in which I wasn’t made to feel like I was rudely taking up too much of my provider’s time.

A Wall Street Journal piece details how some eye doctors feel pressured by their non-doctor bosses to perform far more eye surgeries in a day than they feel comfortable doing. In the New York Times, veterinarians at private equity practices say they are pressured to increase the “cost per client” or see as many as 21 animals per day.

I’ve been upsold at dental and vet appointments and I do not like it. I am paying for their professional expertise, and I should be able to trust them. But now, I always question whether the treatment being recommended is necessary and helpful or just profitable.

People who become doctors, dentists, veterinarians, pharmacists, etc. presumably chose their career because they wanted to provide professional care and they expected to make a comfortable living doing so. People who work in private equity don’t care about the quality of care for the businesses they acquire, and they don’t just want a comfortable living. They want to make a fortune.

It’s not just the care professions

It’s everything. A story in the Harvard Business Review talks about private equity firms finding ways to improve businesses’ “performance.” As an example, it says, “since taking Toys ‘R’ Us private in 2005, KKR, Bain Capital, and Vornado Realty Trust have had to replace the entire top management team and develop a whole new strategy for the business.”

That “whole new strategy” they came up with explains why it’s so hard to buy toys for my grandchildren now. The plunderers closed all the Toys ‘R’ Us stores in 2018, although they’re now attempting to stage a comeback.

You can see asset-stripping in the restaurant world, too. A story in Salon explains how a hedge fund complained that Olive Garden was in trouble for giving away too many breadsticks. That might sound halfway believable if, like me, you ever took growing teenagers there and watched them put away basket after basket of free breadsticks.

But the real issue was more along the lines of forcing Olive Garden to sell the real estate it sits on and then rent it back at punishingly high rates. That strategy doesn’t make sense, of course, if you want to keep the restaurant open. It makes lots of sense if you want to extract as much money as you can as quickly as you can and don’t care whether the business survives.

I used to be the editor of a daily newspaper owned by a hedge fund. Each time I had to cut a corner that I didn’t want to cut, I died inside a little bit more. I, as editor, was not able to decide how to allocate resources, and I was not provided with the funds I needed to do the job right. (A character who works as a reporter in my novel The Trailer Park Rules lives through a similar hell.)

All I wanted to do was bring the public the news. I assume what I felt is very much like the feelings of someone who wants to take care of animals or people or just feed people affordable Italian food.

What do private equity and hedge funds do besides extract money from people who are trying to accomplish something good? So many children dream of growing up to be a vet. Or a doctor. Maybe even running a restaurant. I dreamed of being a reporter. Were some kids dreaming of extracting wealth from others no matter how much mayhem and pain they caused?

The uninformed public simply blames inflation and greed. But don’t blame professionals for the high cost of care. They aren’t keeping all that money you just paid them. Some investors who have never cared for anyone but themselves sure are tucking it away, though.

About Michelle Teheux

I’m a writer in central Illinois. If you like my work, subscribe to me here or on Medium. My new book is The Trailer Park Rules.

A version of this piece ran on Medium on June 5, 2024.