Just 44 percent of physicians owned their practice in 2022 compared with 76 percent in the early 1980s, according to a report from the American Medical Association. What does this shift mean for physicians and their autonomy?
Here is what three physicians have to say about the state of physician autonomy.
Note: Responses have been lightly edited for length and clarity.
Braden Batkoff, MD. Chief Medical Officer of United Cardiology Partners: Given the growth of procedures moving to the ambulatory space, I predict the emergence of new hybrid employment models different from pure private practice or current hospital employment. I see physicians wanting to preserve a sense of autonomy and have the ability to diversify their revenue by participating in ambulatory economics while maintaining alignment with health systems.
Jayesh Dayal, MD. Anesthesiologist at White Flint Surgery (Rockville, Md.): As a standalone ASC, we seem to have no negotiating power with any of the insurers and seem to be at the bottom of the procedure reimbursement rungs. The larger health systems, with access to hospital outpatient department rates and private-equity-owned ASCs, with their nationwide heft, seem to be able to negotiate enviable rates for the same procedures. The days of standalone ASCs are numbered, and we will be forced to sell or partner with these consolidators for survival, defeating the whole concept of physician autonomy and pride of ownership that motivates physicians to undertake ASC ownership in the first place.
Sheldon Taub, MD. Gastroenterologist at Jupiter (Fla.) Medical Center: 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.
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.