As a senior doctor at a privately owned healthcare facility some years back, one of Dr Sandra’s biggest stressors was attending financial meetings with management.
Dr Sandra would respond that not all cases required surgery — some patients only needed biopsies and did not require admission. “But I noticed a disconnect between the medical and financial directions of the organisation, which made it hard to navigate. By the end of my contract, after discussing with senior colleagues, I finally found the courage to start my own practice.”
While veterinarians in the US still own a majority, or 51 per cent, of the roughly 34,000 vet clinics, private equity firms have rapidly increased their presence in recent years. Critics argue that a focus on profitability could drive up patient costs, shift priorities away from quality care, and lead to an increase in unnecessary procedures or services designed to maximise revenue.
According to data from Bain & Company, a management consulting firm, healthcare was Southeast Asia's second-largest sector for private equity investments by value in 2023, while leading the market in buyouts. The investment in the multi-specialty private healthcare group was made via SeaTown’s private equity fund.
While the exact number is difficult to determine as deals are not always publicised, he believes such private investments will continue, just like in the US and the United Kingdom. In the context of Singapore’s healthcare sector, experts told CNA TODAY that while private equity firms generally aim to preserve the core mission of serving society, the operational changes they introduce can sometimes lead to tension.
Based on developments in the US, some healthcare practitioners, such as Dr Tan Yia Swam, have reservations about how the sector will evolve alongside the growing involvement of private equity. Dr Tan, also a former Nominated Member of Parliament, added that if she were to sell her practice to a private equity firm, she might receive some cash upfront from the acquisition, but she would likely have to work much harder to meet the financial targets set by investors.
“Employees who feel the environment has become more profit-driven may choose to leave. This can lead to burnout and further impact patient care, making it difficult to balance efficiency with staff well-being,” she said. “I couldn’t focus on my work for months because plans kept changing," said Ms Chelsea, who spoke on condition of anonymity.
Dr Lim, who is from the Saw Swee Hock School of Public Health at the National University of Singapore , said it is “naive” to believe there are no external pressures as “we are all subject to them”. He also rejected the idea that a profit-driven culture took over his workplace after the acquisition, pointing out that many healthcare professionals prioritise ethical standards in patient care.
Dr de Asis said being part of a larger corporation offers several advantages, such as increased resources. But one key area to adapt to was budgetary oversight, which required his team to be more mindful of expenses and strategically prioritise investments.While several clinics may receive private equity offers, some doctors believe there is value in maintaining independence.
With increasing investor interest in Singapore, could the city-state be in for a similar prognosis? Unlikely, experts told CNA TODAY, given the nation’s healthcare sector operates differently from that of the US. What about the management pressures and financial targets that doctors and staff at private equity-backed clinics may grapple with to earn more profit?
“But this can be balanced by doctors and health professionals within the system. It's important for them to stand up to CEOs and say, ‘This might improve profits, but it's unethical. I can't recommend treatments a patient doesn't need’,” he said. In veterinary care, Dr Brian Loon, a principal veterinary surgeon at Amber Vet, agreed that competition has gotten stiffer and his team must carefully manage rising costs and not fully pass them on to customers.