By Lambeth Hochwald

With the rapid rise in consolidation from hospitals and private equity firms, the old-fashioned private medical practice, run and managed by one or two physicians, is no longer the norm.

Only 42% of doctors were in private practice in 2024. This contrasts with the 60% who ran their own offices in 2012, according to a recent report. That same study found that corporate entities, including health insurers and private equity-backed companies, employ 23% of physicians, up from 15% in 2019.

So what does it take to hang up your own shingle — and keep it affixed — during these challenging times? Staying laser focused on patients helps, Sonali Majmudar, MD, an allergist with two offices in the Chicago suburbs.

“As someone who plans to stay in solo practice, I’m intent on tailoring patient care to their individual needs,” said Majmudar, who employs eight staffers. “I’m probably making less money working on my own, but I believe you’ve got to do what your heart tells you.”

For Ryan Sultan, MD, a psychiatrist in New York City, who is the medical director of Integrative Psych, with three healthcare providers working in offices located in three states, it comes down to a matter of personal values.

“When you choose between running a private practice and taking a corporate job, remember what shaped you,” he said. “Physicians train for a decade or more to think critically, act ethically, and put patients first — even before ourselves. Medicine is a calling built on trust, not quarterly returns.”

By contrast, private equity, venture capital, and corporate healthcare, by design, serve shareholders, Sultan said.

“Its duty is financial,” Sultan adds. “Ours is ethical. When those priorities clash, which they regularly do in healthcare, ask yourself: Who do you want to answer to?”

A 2025 Dermatology Practice Issues Survey found:

- 1 in 6 dermatology practices are private equity owned.

- 17% of doctors surveyed reported that a private equity company owned their workplace.

- 50% of surveyed physicians think being bought by private equity worsened patient care.

- 57% of surveyed doctors think being bought by private equity worsened administrative-doctor relationships.

Reach Out To Regional Practitioners

When you’re running your own practice, it can help to network with other practitioners in your area and create strategic partnerships with local labs, urgent care centers, and clinics.

“Let’s say you’re a two-person pediatric group, and down the street there’s a 20-physician multispecialty group,” advised Susan Bankston, MD, a pediatrician in Baton Rouge, Louisiana, who leads a multispecialty physician-owned-and-run clinic with 200 physicians and a board member of The Physicians Foundation, a nonprofit that helps support medical practice sustainability. “If you reach out, you may find that they need more pediatricians to lend a hand.”

Offering to give a short talk at a local school or senior center in your town can also help bolster business.

“During your presentation, you’ll be teaching people about your field and explaining what you do,” said Sultan. “Doing this sort of grassroots work is really important when you’re running your own solo practice. It can also lead to referrals because more people in your area will have met you and will spread the word that you’re available to care for them.”

Lean Into Technology

The key to remaining in private practice includes tapping into technological tools and leaning into innovation, said Jordan Weiner, MD, president of Valley ENT, an otolaryngology practice run by physicians.

“Since many of the reasons physician practices are acquired include the increasing challenges of information technology and negotiating with third-party payers, we have the size and scope and professional management to do these well,” said Weiner of the practice, which, since its inception in 2007, has grown from 13 physicians to nearly 40-plus mid-level providers serving much of the state of Arizona — which has driven interest by private equity firms.

Some of these tools include automating human resources, patient outreach systems, and patient records.

“Having all of this in place helps reduce the need to rely on being acquired by a hospital system,” Weiner said.

Advocate for Better Reimbursement

Issues of equity in reimbursement remain one of the biggest threats to physicians in private practice, said Mara Holton, MD, a urologist in Annapolis, Maryland, and health policy committee chair of the Large Urology Group Practice Association, which represents more than 1800 independent urologists across the US.

“There’s a tremendous disparity in the marketplace such that reimbursement is lower in independent settings even though costs are higher,” said Holton, who has been in practice for 20 years.

For change to occur, it’s critical for doctors in private practice to speak up — and fight for fairness.

“We need physicians to advocate for policy and regulatory support,” she said. “By engaging with local and national legislators and regulators, we can work towards favorable reimbursement reform that promotes independent practices.”

Be a Savvy Business Owner

One of the most feasible ways for private practices to stay private is to manage their spreadsheets and balance their expenses and earnings, especially if they’re experiencing a downturn in overall revenue.

“If that’s the case, you need to look at ways to cost save,” said Brian Santin, MD, a vascular surgeon who has been in private practice in Wilmington, Ohio, for over 12 years. “Start by looking at your expenses. For example, if you’re paying too much for your surgical packs, go to your vendor and ask if you can bulk purchase them, just like a hospital system would.”

And, as a good employer, it’s really important to make sure to prioritize your employees since staff turnover can often become one of the biggest costs you will face as the owner of a solo practice.

“We treat our employees really well and profit share with them,” said Santin, who majored in economics as an undergrad and currently has six staffers working for him. “I look at all the variables and then think of all the time it will take to train a new employee. That’s costly, so I want to do what I can to prevent that — and keep my team in place in the process.”

Taking time to apply even some of the tactics these doctors do may help you keep the doors open and be able to keep private equity at bay.