Independent physician practices can thrive without private equity — here's how

Physician ownership of medical practices has been on a steady decline, driven by rising costs, burnout, and a shrinking entrepreneurial spirit among younger doctors. With the Medicare Physician Fee Schedule down roughly 26% in inflation-adjusted terms over the past two decades, many physicians have turned to private equity as a financial lifeline — but experts say it doesn't have to be that way.

Legal, financial, and clinical experts outline four practical paths for physicians who want to stay independent: making strategic adjustments to the current model (like "tuck-in" acquisitions of smaller practices), pursuing active growth through debt financing and ancillary service expansion, joining physician-led "supergroups" to share infrastructure and cut costs, or cautiously accepting minority investor stakes while retaining majority control.

By the Numbers:

• Physician ownership dropped from 60% to 44% between 2012 and 2024
• 56% of physicians now work for hospitals, health systems, or corporate entities
• The Medicare Physician Fee Schedule has fallen ~26% in inflation-adjusted terms over 20 years

Why it matters: As consolidation accelerates, independent physicians risk losing both autonomy and patient-centered care. These strategies offer a roadmap for staying viable without surrendering control to investors whose priorities may not align with clinical values.