The following editorial was published in The Hartford Courant on December 11, 2025.
By Talal Khan, MD
The most meaningful decisions in health care, those that impact people’s lives every day, should remain between the doctor and the patient. That principle guided me to found my own independent practice and remains at the heart of how I approach medicine.
Being part of a physician-owned and physician-governed network helps make that independence possible. Networks like this allow small practices to remain autonomous while gaining access to shared tools that strengthen care, including data analytics, care coordination and quality improvement resources.
In hospital- or insurance-owned networks, decisions are often shaped by financial or institutional priorities. In a physician-led network, clinical judgment stays where it belongs: with the clinicians who know their patients best.
This difference matters. Large systems can sometimes prioritize utilization, cost cutting or investor goals over the long-term well-being of patients. Independent, physician-governed models focus instead on patient outcomes, continuity of care and the health of local communities.
For smaller practices like mine, the benefits are practical and immediate. Through our network, I can access value-based care contracts that would otherwise be out of reach, giving my patients the advantages of coordinated, outcome-focused care. Collective negotiating power means fairer payer contracts and greater financial stability — both essential for maintaining independence. And perhaps most importantly, I can enjoy the scale and support of a large network while preserving my practice’s identity, culture, and patient-centered values.
Pressures on Independence
Maintaining independence in today’s healthcare system is challenging. The days of paper charts and simple billing are long gone. Physicians now face layers of regulation, complex quality reporting requirements, prior authorizations and evolving billing codes. On top of that, staffing shortages and burnout – worsened since the pandemic – have stretched many practices thin. Economic pressures and industry consolidation make it even harder for small practices to survive.
Networks focusing on independent practices provide a path forward. Collective contracting helps reduce financial strain, while centralized support for compliance, quality, and reporting lightens administrative burdens. These shared resources allow physicians to spend less time managing bureaucracy and more time focusing on patients. Being connected to a community of peers also helps reduce isolation and strengthens our collective voice.
When independence disappears
When independent practices are absorbed by hospital systems or corporate entities, something essential can be lost — both for physicians and for patients. Autonomy erodes, decision-making shifts upward, and patient care often becomes more standardized and less personal.
Larger systems, driven by financial performance goals, may unintentionally prioritize profit over personalization. Patients can experience fragmented care, higher costs, and less continuity with their doctors. The “one-size-fits-all” model that can emerge under the banner of population health often overlooks the deep understanding that comes from long-term doctor-patient relationships.
The small, community-based practice — the kind where your doctor knows your story and your family — remains one of the most effective and compassionate models for delivering care. Preserving it isn’t about nostalgia; it’s about maintaining the kind of trust-based, relationship-based medicine that puts people first.
Much of health care’s future lies in value-based care, which rewards quality and outcomes over volume. Done right, it aligns incentives around what matters most: keeping patients healthy. For physicians, this means focusing on prevention, coordination and long-term results. For patients, it means personalized attention, better communication and care designed to maintain health rather than simply treat illness.
True value-based care also emphasizes efficiency and innovation. Using technology and AI thoughtfully, ordering tests wisely, and integrating evidence-based medicine all help achieve the best results at the most reasonable cost. When physician-led organizations drive these efforts, the result is healthcare that is both humane and sustainable.
Independence and Well-Being
Independence also supports physician well-being. Having control over clinical decisions, scheduling, and the culture of one’s practice contributes directly to job satisfaction and purpose. When doctors feel empowered, they deliver better care.
Conversely, when autonomy is lost, burnout rises. Physicians who feel like they’re working within rigid corporate systems can lose the sense of fulfillment that first drew them to medicine. Independence allows physicians to reconnect with why they chose this profession — to serve, to heal and to build lasting relationships with patients.
In a time when health care can feel increasingly impersonal, independent practice offers hope. It preserves the human connection that makes medicine not just a science, but a calling.
At its heart, independence is about protecting the soul of medicine — ensuring that care decisions remain guided by compassion, expertise and the unique needs of each patient. When doctors are able to truly focus on patients rather than paperwork or profit targets, everyone benefits: physicians, families and entire communities.
Talal Khan, M.D., is a physician with Personal Primary Care and Weight Management, LLC. He is also a member of Southern New England Healthcare, a network with 600+ primary and specialty care physicians and advanced practice providers located throughout Connecticut and Western Massachusetts.