Independent primary care is disappearing. Out of 174,561 physicians, between age 31–40, more than 80% now work in corporate-owned practices. Young doctors aren’t choosing this. They’re entering a system where independence no longer feels like an option. And when physicians lose autonomy, patients lose something too, real relationships, time, trust, and transparency. They become a number and not a name. We can’t keep pretending consolidation is harmless. It has to change because it's changing the ❤️ of healthcare. Independent physicians built American medicine. We owe it to the next generation to make that possible again. Chart from Journal of General Internal Medicine (JGIM): Wang et al., “Commercial Prices for PCP Office Visits” 2025 #Healthcare #PrimaryCare #PhysicianLeadership #HealthcareManagement #MedicalPractice #standardizednotpersonalized
Great post. As an Independent physician who worked on Employer side, I think I can speak- first hand. I received little to none education on how to run a Business or how the healthcare system works. Physician are not trained in Nutrition, even in Primary care setting. With little knowledge of Business world, scared of legal and administrative burden most choose to be employed. However I see Physicians who are fed up of the system taking risks and starting on there own and providing great patient care- where the only incentive is to keep the patient healthy. Physicians should start taking more risks, get educated about Finance, Business and not get Intimidated. If we can stop the bleed, support the dying patient then we should be able to handle the mundane things.
As a doctor that worked in academia and then for a private practice that sold to PE…and then left to open my own practice, I have never been happier or felt like I’m practicing in line with my morals as I do now…the system is broken and medical students need to be taught how to open a practice and start on their own…there should be grants they apply to to help get them started - especially in primary care. The DPC movement is doing just that and the satisfaction rate is high- for both doctors and patients!
Young doctors are tired of years of training and the stability of employment initially looks attractive. It takes an extra amount of bravery to venture out into independent practice
This has been a problem for decades. the AAMC estimates we are 20,000 primary care docs short now and will be over 40K by 2036. Of 3139 primary care residencies in 2024 252 went unfilled and it was even worse for family practices. Physicians owned by corporations is a massive problem. Not only does it limited practice and referral protocols, but it drives the cost care up significantly. United Health Group owns over 90,000 physicians of nearly 10% of all US docs and growing. They have 2694 subsidiaries with 423 being ASC's and over 880 are home health. Other carriers are following suit not to mention how many health systems own significant portions of their local physician populations. We are rapidly moving to Corporate Healthcare not National Healthcare let alone private healthcare.
Im with you Kimberly Carleson but HOW this can be solved that is the real question - because it’s definitely attractive for young doctors to go this way after years and years or studying, internships etc… and maybe that is ok? Not everyone has entrepreneurial mindset- which is basically the mindset an independent doctor needs to have - so is it that off that they choose to have a corporate job first, learn, and then go into an independent practice type of business? What do you think?
#POTUS is missing a rare opportunity to set right the "forced maleficence" in health industry. Realigning incentives to ensure competition and appropriate care in appropriate settings is the need of the hour. Otherwise, patients are doomed to excessive amounts of useless care in large hospital systems. About 70% of what is done in hospitals can be done in O/p settings. Do not expect doctors to run business at loss. Proponents of ACA were not told this in 2008.
This is why I love working for CLS Health in Houston, TX. We are offering doctors the opportunity to practice medicine how they want to without the corporate-ness. We take care of Marketing, RCM, billing, etc and they get to focus on their patient care. It’s healthcare how it should be! 20 years of being physician led, physician owned and we continue to grow double digits year after year. And no, we don’t answer calls from PE. ☺️
Kimberly, the loss of independence doesn’t happen in one moment — it builds over years of financial and operational pressure. Supporting practices through that transition, we often find the same pattern: shrinking margins, rising administrative burden, and a backlog of unresolved MA underpayments that went unnoticed while clinicians tried to keep up. When those dollars disappear, autonomy disappears with them.
I say it for the 100th time. Physicians should not be employed by hospital system or insurance companies. ITS A CONFLICT OF INTEREST.
Ask yourself who sold said practices ? Docs , they got a windfall selling to PE or health system. It looks this way because they sold..