By: Margaret Chustecki, MD, MBA, Internal Medicine of Greater New Haven
The growing trend of independent practices being absorbed by large hospital systems, insurance companies, or private equity firms presents serious risks to the future of patient care and the integrity of the medical profession. While consolidation may offer some operational efficiencies or negotiating power, it often comes at the cost of clinical autonomy, innovation, and patient-centeredness.
One of the most troubling consequences is the shift in focus from individualized care to system-driven metrics and financial performance. Physicians employed by large systems are frequently pressured to meet productivity quotas, see more patients in less time, or refer strictly within system-owned networks—regardless of whether that serves the patient’s best interest. This environment threatens to undermine clinical judgment and devalues the physician-patient relationship, which is essential to providing high-quality, ethical care.
In addition, consolidation reduces diversity and competition in the healthcare marketplace. As more independent practices are acquired, patients have fewer options and less flexibility in choosing providers. Care becomes increasingly standardized, often at the expense of local responsiveness and adaptability. With fewer independent voices, innovation slows—especially the kind that comes from small, community-based practices tailoring solutions to unique patient populations.
The financial implications are equally concerning. Studies have shown that when hospitals acquire physician practices, the cost of care typically increases. Higher rates are charged for the same services, and these costs are often passed on to patients in the form of increased out-of-pocket expenses or higher insurance premiums. Importantly, these price hikes do not always reflect improved outcomes, raising serious concerns about value and sustainability.
The growing involvement of private equity firms in healthcare adds yet another layer of risk. These investors are typically focused on short-term profitability and rapid expansion, which can result in cost-cutting measures that compromise care—such as reduced staffing, shortened appointment times, or limited service offerings. This type of financial model prioritizes return on investment over patient well-being, which can have lasting effects on both care quality and physician morale.
The disappearance of independent practices also has broader implications for the future of the medical profession. Independence allows physicians to advocate more freely for their patients, to spend more time on prevention, and to focus on long-term outcomes rather than quarterly earnings. Losing that independence can erode the sense of medicine as a vocation rooted in service and compassion, replacing it with a corporate model that prioritizes volume and efficiency over relationships and reasoning.
Protecting the space for physician-led, patient-centered care is essential—not only for those currently practicing, but for future generations of doctors and patients alike. Independent practices bring a necessary balance to a system increasingly dominated by profit and scale. Without them, healthcare risks becoming a commodity, where clinical decisions are driven not by what’s right for the patient, but by what’s best for the bottom line.
