Private practice is at a crossroads. As reimbursement tightens and consolidation accelerates, physicians are rethinking how to preserve autonomy, financial stability and control over patient care.
These five trends show how independent practice is evolving, and what it will take to survive in today’s healthcare landscape:
1. Direct primary care and alternative models are gaining momentum as physicians seek autonomy: Direct primary care is one of several emerging independent practice models being explored, as physicians look for greater autonomy and patients seek more direct access to care.
Some physicians are drawn to DPC because its membership-based structure offers more flexibility in care decisions than traditional fee-for-service reimbursement. Leaders also note DPC is generally considered less expensive than concierge medicine, and recent federal policy changes will allow some patients with high-deductible health plans to use health savings accounts to pay for direct primary care arrangements.
2. Physician-led platforms and MSOs are offering alternatives to traditional consolidation: While private practices face mounting financial pressure, new partnership models are emerging to help physicians preserve independence while gaining operational scale.
In 2025 alone, at least nine new physician-ownership platforms and management service organizations launched with a focus on autonomy. Groups such as Charleston, S.C.-based Articularis Healthcare Group and Franklin, Tenn.-based Regent Surgical Health continue expanding physician-aligned models, while healthcare startup Meroka recently launched with $6 million in seed funding to support independent practice operations and reduce administrative burden.
3. More physicians are pursuing business training to prepare for private practice leadership: Physicians are increasingly seeking dual MD/MBA degrees and other business-focused training to better navigate the financial and operational demands of independent practice. According to a 2025 report from the Association of American Medical Colleges, 9% of medical students are pursuing dual degrees, with some institutions reporting rising enrollment in MD-MBA and MD-MPH programs.
“Getting an MD alone is practically worthless in today’s [leadership] environment,” Regis DeSilva, MD, a cardiologist and associate professor of medicine at Harvard Medical School in Boston told Becker’s.
4. More employed physicians are looking back to private practice for autonomy: While employment has grown in recent years, a segment of physicians is pivoting back toward private practice. A Bain & Co. survey found that nearly 25% of physicians in health system-led organizations are considering changing employers, compared to 14% in physician-led practices, and 37% of those contemplating a move are looking to transition to physician-owned settings.
Surveys also show autonomy gaps: 61% of employed physicians reported having moderate or no autonomy in referral decisions. Meanwhile, 81% of physicians in physician-led organizations said they were satisfied with their involvement in strategic decision-making, compared to 50% in health system-led practices. Leaders say dissatisfaction with administrative control, burnout and decision-making authority are fueling renewed interest in independent practice models.
5. Risk-based contracting and consolidation pressures are reshaping private practice strategy: As healthcare shifts toward risk-based payment models, independent practices are struggling to compete without the scale, infrastructure and contracting leverage of larger systems.
Leaders say small and mid-sized groups are often disadvantaged in payer negotiations and care coordination, prompting more physicians to explore partnerships, independence-focused platforms or alternative models such as employer-built health plans that offer faster payment and reduced administrative friction. At the same time, recent federal policy changes easing merger scrutiny could further accelerate consolidation, raising new questions about long-term negotiating power and practice sustainability.
