Independent Practice

Physicians' sense of autonomy in employed settings and their ability and inclination to operate an independent practice have dually declined in recent years, becoming a central concern for physicians across specialties. 

Autonomy is on many physicians' minds as the workforce becomes increasingly consolidated and the number of employed physicians grows. 

Physician autonomy is a central concern for physicians and physician leaders heading into 2025, as just 44% of physicians owned their own practice in 2022, compared with 76% in the early 1980s, according to the American Medical Association. 

Physicians in private practices have been fighting for survival over the last several years as reimbursement rate declines paired with rising practice costs have forced many practice owners to make difficult choices. 

Management service organizations are becoming increasingly powerful in healthcare, particularly in gastroenterology, orthopedics and ophthalmology, Medical Economics reported Oct. 1. 

As reimbursements from CMS and other payers continue to be misaligned with the cost of keeping practices afloat, physicians face difficult choices about how to lead their practices into the future. 

Here are three policy changes that independent physicians say would make a difference in the fight to keep the doors open in the age of healthcare consolidation:

The independent healthcare market is shrinking as consolidation climbs, reimbursements fall and inflation remains high. Here are five notes on the state of physician independence:

Nearly 80% of physicians now work in an employed setting. Here are five ways the remaining 20% keep their practices independent: 

Many smaller private or physician-owned practices have found themselves at a critical junction in recent years. Independent physicians are declining in numbers as the reach of consolidation widens, economic pressure intensifies and administrative burdens persist.