By Patsy Newitt

As independent practices struggle to keep pace with consolidation, a contingent of physicians is responding with an entrepreneurial turn.

Between 2012 and 2024, the share of physicians in private practice fell by nearly 20 percentage points from 60.1% to 42.2%, according to the Physician Practice Benchmark Report. Facing hospital employment contracts, private equity acquisitions and the capital demands of value-based care, some physicians are building new ownership structures, management platforms and venture funds to preserve clinical autonomy and financial independence.

“The number one reason I think people go into private practice is autonomy,” said Shobhit Minhas, MD, an orthopedic surgeon at Fox Valley Orthopedics. “Because in private practice, you set your own rules. You set your own hours, to an extent, and you’re kind of in control, in the sense that you eat what you kill…It takes a certain type of person that’s willing to bet on themselves. But those are the same types of people with an entrepreneurial spirit.”

Independent practices have continued to struggle to keep pace with the capital requirements of transitioning to value-based payments while competing against large health systems, private equity firms and payers with far greater resources.

Even amid such headwinds, those working in physician-backed groups often report a higher level of satisfaction. According to a survey from consulting firm Bain & Co., average satisfaction for physician-led organizations ranges from roughly 70% to 90%, compared to 50% to 75% in health system-led practices. Additionally, 78% of physicians in physician-led practices report that their organizations have effective processes and workflows, compared to 59% in health-system-led ones.

The infrastructure to support physician entrepreneurship is also scaling rapidly. In 2025, 13 management service organizations were tracked, that launched with an explicit mission of keeping practices independent and providing operational resources without requiring a traditional acquisition. At least nine new physician-ownership platforms also launched that year with a focus on autonomy.

On the flip side, the entrepreneurial wave is running into a structural obstacle, as many physicians lack formal training on how to run a business. According to a 2022 study in the National Library of Medicine, 79% of medical trainees reported below-average understanding of personal finance, despite nearly all agreeing that this education should be an integrated part of their training. According to Encoda’s “The state of financial health” survey, only 47% of physicians expressed confidence that their current financial reporting accurately identifies issues and financial risks.

Incoming physicians are increasingly seeking to close that gap. According to a 2025 report from the Association of American Medical Colleges, 9% of medical students are pursuing dual degrees, with institutions reporting rising enrollment in MD/MBA and MD/MPH programs.

According to the AAMC report, those pursuing business administration are often doing so out of desire to improve how healthcare systems operate.

Physician leaders have also said that business skills are necessary for physicians looking to step into executive or leadership roles at healthcare organizations, but are rarely taught in traditional medical school environments.

“Getting an MD alone is practically worthless in today’s [leadership] environment,” said Regis DeSilva, MD, a cardiologist and associate professor of medicine at Harvard Medical School in Boston. “The reason for that is that it’s been taken over by MBAs and business people, and they don’t pay any attention to garden-variety MDs.”

Two sectors in particular are emerging for physician-led ventures. One is clinical AI and software. Ambient documentation tools, diagnostic AI, and clinical workflow platforms are technically demanding to build credibly, and non-clinicians often struggle to get them right. Abridge, founded by practicing cardiologist Shivdev Rao, MD, raised $300 million in June 2025 at a $5.3 billion valuation and is now deployed across more than 100 U.S. health systems. Ambient clinical documentation has attracted $600 million in investment, with coding and billing automation drawing an additional $450 million, according to Menlo Ventures’ 2025 state of healthcare AI report.

The second is health and wellness, specifically fitness, nutrition and longevity medicine. Darshan Shah, MD, a board-certified surgeon who trained at Mayo Clinic, founded Los Angeles-based Next Health in 2016 as what the company describes as the first health optimization and longevity center of its kind. The company has since expanded to multiple locations and, in October 2025, it launched a scientific advisory council that includes prominent physicians in functional and preventive medicine.

The entrepreneurial push is extending into capital markets. In 2021, AlleyCorp launched a $100 million physician-led venture fund focused on digital health startups. In September, healthcare technology start-up Meroka, which helps independent physician teams through a platform that supports practice operations, launched with $6 million in seed funding.”Independent doctors are some of the most entrepreneurial and mission-driven professionals out there,” Alex Barrett, CEO of Meroka, said. “But too often, they are forced to spend more time managing vendors and paperwork than leading their teams and caring for patients.”