The Fall of Independent Practices and Practitioners

Samantha RebaJunior Writer

Most doctors take pride in owning their own practice and being independent employers. They view hospitals as institutions where they extend care to their patients. Not as a place of employment. But as the healthcare climate changes many physicians are foregoing the independent route and becoming hospital employees.



The only way that independent practices are going to survive is if:

  • They’re exceptional in their field of work or one specific field (ie, gynecology or dermatology)
  • They can keep up with new, cutting edge technology and practices
  • Maintain their names and practice outside of hospital walls.

The main problem that is targeting independent practices is the lack of specialists that are willing to join the ranks of a practice outside of a hospital. Without these specialists, these independent practices are going nowhere fast, while hospital staff is growing.



Today, less than half of doctors in the United States own their own practices. This is due to the cost of maintaining a practice and still being able to generate a profit at the end of the day.

“Last year, 47 percent of physicians in the U.S. were employed by hospitals – roughly twice the percentage in 2002.” Surveys by the Medical Group Management Association.

This percentage is drastically increasing each year.

Additionally, doctors are finding it hard to find a balance between their work and personal wellness. There are so few doctors in practices because with two or less doctors on site, doctors are taking on increasingly more patients, which not only increases stress but also decreases personal wellness. A downward cycle starts of increased stress and decreased personal wellness resulting in an independent physician no longer able to keep up with a practice.

The decline in independent practitioners affects other healthcare services; independent laboratories for one. With fewer independents practitioners, hospitals and health systems may be more inclined to use only certain medical laboratories and skip over independent laboratories that were once supported by independent practitioners.

The facts are simple. Younger practitioners are uncomfortable owning their own practices due to their lack of experience and expenses, while middle aged and older physicians are looking for jobs that will ease them into retirement and provide some cushion once they’re done working.

“Almost twice as many physicians under 40 years old (46 percent) are looking for employment compared to their peers age 55 years and older (25 percent).” 2007-2008 AMA Physician Practice Information Survey.

The fast decline of independent physicians is overwhelming. If this trend continues we may see fewer independent physicians except for specialists who have evolved along with the medicine and treatments