Nearly three-quarters of physicians are employed by a hospital or some other corporation, according to 2022 data . This isn’t good news: Ownership of physicians is driving up costs for patients, raising questions about quality, and diminishing personalized care.

Soaring healthcare costs are the biggest concern for the public. In February 2022, AffordableHealthInsurance.com, for example, surveyed adults and found that 56% of those with insurance still have medical debt. Those costs are higher when physicians are employed by hospitals or by private equity groups .

While most people are familiar with physicians being owned by hospitals, many are surprised to learn that in some metropolitan areas, private equity controls 50%-70% of the market in anesthesia, dermatology, gastroenterology, and other specialties. The single biggest employer of physicians is Optum, a division of United Healthcare . Patients have no choice in such a setting.

Ownership by non-clinicians forces adherence to metrics that are unsafe for patients. For example, Envision, a national staffing company, encouraged emergency rooms to employ "the least expensive resource" and treat up to 35% of patients with midlevel practitioners, according to a 2017 PowerPoint.

This is the playbook that many of these private equity staffing companies use: Metrics are geared toward maximizing profits, not quality or safety. The most notable example was in 2020 when Team Health terminated an ER physician for expressing concern over the lack of protective equipment for staff and patients during the pandemic.

The patient-physician relationship is based on trust and respect and is critical in delivering the quality of care needed to address a patient’s needs. Corporate demands are an obstruction to that all-important personal relationship and can limit whether a patient can even see a licensed physician. Because of corporate involvement, patients are more frequently seeing non-physicians .

In the absence of leadership from legacy associations, physicians and advocates are forming groups to protect patients. One such group is the Association for Independent Medicine, whose mission is to address the loss of independent physicians to private equity, hospitals, and other entities. Independent physicians are the last line of defense against the corporate practice of medicine, and their numbers are dwindling to the detriment of communities around the country.

These groups believe that maintaining physician control of healthcare decision-making results in the highest quality of care for patients and the most efficient use of healthcare resources.

As a full-time independent practicing physician, I answer only to my patient and the care I provide. The entities that extract exorbitant profits while creating little value will have you believe that physicians are the culprits in the system. Those corporate entities are hitting people in the wallet while eroding quality. They are driving physicians out of medicine, and they are creating an army of temporary workers that will tax the system at a much more rapid pace.

Marco Fernandez has practiced for 20 years as a cardiac anesthesiologist and is on the board of directors of the Association for Independent Medicine .