As private equity investors turn their attention to law firms, a New Jersey trial lawyer is urging the profession to examine a question that has followed similar investments in healthcare: Do the people receiving the service benefit?

In an article for Above the Law, Michael J. Epstein, managing partner of The Epstein Law Firm, argues that the healthcare experience offers both opportunities and warnings for lawyers considering outside investment and management services organizations.

Private equity firms have invested heavily in physician practices, hospitals and specialty groups, often promising better technology, stronger management and greater efficiency. Similar arguments are now being made in the legal sector, where management companies could handle functions such as staffing, billing, marketing and technology while lawyers retain ownership of their practices.

Those services could address genuine weaknesses in professional businesses, Epstein writes. Lawyers who excel in court may have little interest or training in managing a large organization. Better case-management systems, additional staff and access to capital could improve communication and help firms pursue complex litigation.

But evidence from healthcare suggests that stronger financial performance does not necessarily translate into better or cheaper service.

A study published in *JAMA Health Forum* examined private equity acquisitions of dermatology, gastroenterology and ophthalmology practices. Compared with similar practices that were not acquired, the acquired practices saw an average increase of approximately 11% in amounts paid per claim during the period studied. Patient volume also rose.

Another study of private equity acquisitions of gastroenterology practices found higher colonoscopy prices without corresponding improvements in measured quality. The findings do not establish that every investment harms patients: Evidence varies by specialty and organization, and some studies have found little meaningful change in particular outcomes.

For law firms, Epstein identifies a risk that business metrics could begin to drive decisions that should rest with attorneys. Measures such as case volume, revenue and the time a matter remains open can be useful, but they do not capture every aspect of responsible representation. A difficult case may require years of work, substantial expense or a recommendation to reject an early settlement.

Consolidation also raises questions about choice. Familiar local law firms could continue operating under separate names while relying on management businesses controlled by a smaller group of investors.

Epstein does not argue that investment or profit is inherently incompatible with professional responsibility. Instead, he calls for scrutiny of whether savings and growth improve client communication, access and case handling—and whether lawyers remain independent when client interests conflict with financial incentives.