The Nocturnists The Gilded Age of Medicine with Dhruv Khullar, MD
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Jan 23, 2025 Dhruv Khullar, a physician and health policy expert who writes for The New Yorker, explores the complexities of modern medicine, comparing it to a Gilded Age. He discusses how groundbreaking innovations often obscure deep systemic issues like rising costs and misaligned incentives. The conversation dives into the effects of private equity on healthcare, the pitfalls of Medicare Advantage, and the significance of clinicians engaging in health policy debates. Khullar emphasizes the need to address access and equity in the healthcare system.
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Private Equity's Impact on Hospitals
- Private equity acquisitions of hospitals correlate with increased patient harm like falls and infections.
- Hospital assets often decrease post-acquisition, despite claims of capital infusion.
The Gilded Age of Medicine
- Modern medicine is in a Gilded Age, where innovations mask systemic dysfunction.
- This era mirrors the historical Gilded Age, with healthcare's wealth contrasting with its inequities.
Private Equity's Influence on Healthcare
- Private equity firms buy healthcare facilities, sometimes consolidating multiple practices within a specialty.
- This can lead to cost-cutting measures, impacting staffing and resources, or price increases due to lack of competition.
