By Russell R. Barksdale Jr.
Physicians are facing a growing crisis of burnout and dissatisfaction, driven by a combination of economic pressures and an overburdened healthcare system. As the cost of operating a medical practice rises and doctors’ reimbursement rates are being threatened, many doctors are finding it increasingly difficult to provide the level of personalized care they once enjoyed. Though these issues existed before the pandemic, the crisis accelerated the shift toward corporate models of healthcare, which could have lasting impacts on both physicians and patients for years to come.
For doctors, the financial pressures are severe. Key health insurance companies reimburse physicians at incredibly low rates for the services they provide. Their capitated managed care reimbursable rates can force many physicians to see more patients per day and some have reached their capacity of forty (40) patients per day. This translates into shorter and shorter face-to-face visits.
Operating a private practice has become increasingly expensive, as well, with costs rising across every aspect of medical care—from insurance premiums for staff, to the administrative burden of dealing with insurance companies and regulatory requirements. In turn, many doctors have entertained selling their practices or joining healthcare systems, where they may benefit from financial stability, reduced administrative responsibilities, and a more predictable income stream.
The traditional model of independent medical practices has been a cornerstone of American healthcare for decades. Physicians were once able to build strong, personal relationships with their patients—something that many believe is at the heart of quality care. But the rise of corporate organizations, insurance network participation, and discounted reimbursement rates, has transformed this model. Today, many physicians are employed by larger healthcare systems or corporate entities, where they are subject to productivity quota pressures. This can lead to rushed appointments, shorter patient visits, and what patients may feel is an overall impersonal healthcare experience.
The shift to corporate ownership is not without its costs. For some doctors, this new corporate model clashes with their core values as healthcare providers, particularly their desire to offer personalized care. The resulting stress and dissatisfaction are felt not only by physicians but also by their patients, who experience longer wait times, fewer appointment slots, and a general sense of being lost in the system.
In response to these challenges, some physicians are exploring alternative models of care that prioritize personalized medicine over the corporate-driven model. One such model is concierge medicine, which has seen significant growth in recent years. In concierge medicine, physicians maintain smaller patient panels and are able to spend more time with each patient, offering a higher level of care and attention. This model is often based on a membership or retainer fee, which helps physicians maintain financial stability without relying on the traditional insurance-based reimbursement structure. For patients, the benefits of concierge care are clear: quicker access to their physician, longer face-to-face appointment times, and fewer bureaucratic hurdles.
Concierge medicine represents a promising solution to the challenges facing both physicians and patients in today’s healthcare environment. The global concierge medicine market was valued at over $13 billion in 2023, and it is projected to continue growing at a compound annual rate of more than 6% over the next several years. This growth indicates a growing demand for a more personalized, patient-centered approach to healthcare, as more patients and physicians seek alternatives to the corporate model.
However, concierge care is not without its limitations. The membership fees associated with concierge medicine can be prohibitively expensive for many patients, particularly those without significant financial means. As a result, this model remains somewhat niche, accessible primarily to those who can afford it. Physicians can, in turn, operate on a sliding fee scale or adjust based upon their community’s economics.
While concierge medicine offers one path forward, other innovative models are also emerging. Multidisciplinary care teams—which bring together a range of healthcare professionals, including nutritionists, mental health specialists, physician and nurse extenders, and physical therapists—offer a more holistic approach to patient care. By working together, these teams can address a patient’s physical, mental, and emotional needs, providing a more comprehensive and coordinated care experience. This collaborative model is particularly well-suited to managing chronic conditions, which are becoming increasingly prevalent as the population ages.
Alongside these emerging models, some families are turning to patient navigators—independent healthcare advocates who help guide patients through the complexities of the healthcare system. Patient navigators assist with everything from scheduling appointments and coordinating care to understanding insurance coverage and managing medical bills. This can be especially valuable in a system where patients often feel overwhelmed by the sheer volume of information and decision-making required to navigate their care.
The rise of corporate medicine and alternative care models has led to growing concerns about the erosion of physician autonomy. As corporate entities seek to increase their influence over operations and structures, many are finding ways to circumvent corporate practice of medicine (CPOM) laws, which are intended to preserve the independence of medical decision-making. In many states, CPOM laws require that medical decisions be made by licensed physicians, not non-medical corporate entities. In response, some corporate entities have structured their investments in ways that allow them to control the administrative and operational sides of medical practices while leaving the clinical decisions to physicians. This regulatory work-around raises concerns that corporate interests could compromise the quality of care and risks undermining physician autonomy.
The increasing consolidation of healthcare, coupled with rising costs and bureaucratic inefficiencies, has led many to question whether the future of medicine will be driven by corporate entities or by a more patient-centered, personalized approach. For physicians, this question is not just about finances—it’s about their ability to provide the care they believe is best for their patients. For patients, it is about their ability to access timely, compassionate, and effective care in an increasingly complex system.
The answer may lie in finding a balance between the corporate drive for efficiency and the need for personalized, relationship-driven care. While corporate medicine seeks efficiency and cost-savings, it can also contribute to an unintended sense of alienation and stressors among physicians and patients alike.
In the end, the future of healthcare may not be found in a single model but in a hybrid approach that combines the best elements of corporate efficiency with the personal, human touch that makes healthcare so vital. Whether through concierge medicine, team-based care, or alternative models, there is hope that the pendulum will swing back toward a system that values both quality care and physician autonomy—where the needs of patients are prioritized, and the well-being of doctors, nurses, therapists, and providers are fully supported.
Russell R. Barksdale, Jr., PHD, MPA/MHA, FACHE is President & CEO of Waveny LifeCare Network
