Here are three major issues plaguing private practice physicians today.
Consolidation
"Private practice physicians are becoming more and more rare in American healthcare," Kenneth Candido, MD, CEO and president of Chicago Anesthesia Associates, told Becker's. "This is by design and is not random. Large systems are siphoning off private practice physicians and are buying or consolidating practices exponentially. Those who hold out find a shrinking referral base, as those formerly loyal to them are being compelled to exclusively refer within the system. It is a dirty business and a dirty, underhanded game that administrators are playing to monopolize their business models."
Decrease in physician ownership
Physician ownership is on the decline.
In 2022, only 44% of physicians owned their practice, compared with 76% in the early 1980s, according to a report from the American Medical Association.
According to the report, 80% of physicians said the ability to negotiate higher payment rates with insurance companies influenced their decision to sell their practice.
More than 127,000 physicians moved to employment from 2019 to 2023, according to data the consulting firm Avalere gathered in a study sponsored by the Physicians Advocacy Institute.
Loss of autonomy
"Physicians remaining independent are going to be few and far between. They're either going to go with these large equity groups or hospitals or something like that," Sheldon Taub, MD, a gastroenterologist at Jupiter (Fla.) Medical Center, told Becker's. "You still have a quote, unquote, 'private practice,' but you have guidelines and rules that you have to conform to so it meets their criteria. So right away, you feel a little bit of your autonomy being compromised, and then the bigger the group gets, the more restrictions they have on what you can do to stay in the group and conform to what they want you to do. On top of that, the government throws in their regulations too. The private practitioner is a dying breed."
According to Medscape's "Physician Burnout & Depression Report 2024," 32% of physicians reported being burnt out due to lack of control or autonomy. In the same report, 41% of physicians reported that an increase in physician control and autonomy could help with burnout.