Independent Medical Practices Are the Future of Health Care
Let Them Compete
A quiet but vital war is being waged in the American healthcare system. On one side are massive, consolidated health systems, which continue to swallow up private practices, rural hospitals, and clinics in a relentless march toward market dominance.
On the other are independent medical practices—smaller, leaner, and highly efficient operations that stand for what health care could and should be: accessible, affordable, and rooted in patient care.
The difference between the two models matters. Independent practices are uniquely positioned to deliver better care to patients, strengthen local economies, and—perhaps most importantly—restore the trust that has been eroded by a healthcare system increasingly defined by bureaucracy, expense, and opacity.
But to thrive, they need policymakers, payers, and the public to recognize their critical role and give them room to compete.
Better for Patients
Health systems dominate headlines for their scale and influence, but that scale comes at a price. Patients are caught in the churn of mergers and acquisitions that eliminate choice, inflate expenses, and distance care from the patient.
Independent practices, by contrast, provide a more agile, personalized approach. Patients see the same physician year after year, building a relationship that drives better outcomes and prevents unnecessary interventions.
Independents also lead the way on price transparency, a concept that health systems have largely resisted. Where a knee replacement in a major hospital system might carry a list price of $60,000 or more, an independent physician-owned surgical center can deliver the same procedure, often with better results, for a fraction of the price. That isn’t theory—it’s happening already.
Better for Communities
While health systems extract wealth from local economies, independent practices invest in them. Their revenue doesn’t flow to a distant corporate headquarters; it stays local, paying employees, supporting schools, and funding small businesses.
Independent practices offer a lifeline for employers through direct contracting models. By partnering with local doctors and surgical centers, companies can bypass traditional insurance intermediaries, reduce expenses, and give their employees better access to care. This model keeps spending within the community and improves workforce health.
The economic impact is even more pronounced in rural and underserved areas, where a single independent clinic can anchor care delivery. As consolidation eliminates competition, the survival of these practices becomes a public imperative.
A Competitive Advantage for Health
The U.S. spends more on health care than any other nation, yet life expectancy lags behind peer countries. Part of the problem is structural: Health systems are incentivized by sickness. They profit when patients fill beds, not when they stay well.
Independent practices—particularly models like Direct Primary Care (DPC)—are disrupting that paradigm. By charging transparent, upfront fees and removing insurance friction, they prioritize prevention over intervention and focus on long-term patient health rather than episodic, fragmented care.
However, independent practices can only fulfill this promise if they can compete on a level playing field. Policies that stifle physician ownership—such as the moratorium on physician-owned hospitals—must be revisited. Site-neutral payment reform, which ensures that outpatient procedures are reimbursed equally regardless of setting, is essential. Policymakers must push back against consolidation that threatens to erase independent options entirely.
A Path Forward
Independent practices are not a nostalgic relic; they are the path forward for American health care. They offer patients choice, employers value, and communities resilience. Their survival isn’t just in the interest of doctors—it’s in the interest of anyone who believes that health care can and should be better.
The next time a health system touts its latest merger or expansion, ask yourself: Who benefits? Patients and communities don’t need more significant systems. They need better care. Independent medical practices are already delivering it.
Let them compete.
-Rojas out.