In 2024, only 42.2% of US doctors worked in a private practice owned by physicians, down from 60.1% in 2012 [1].
As of January 2024, 77.6% of physicians were employed by hospitals or corporate entities [2]. In little more than a decade, medicine shifted from a profession of owners to a workforce of employees.
While the number of doctors choosing private medicine is going down; the number of doctors opting to open direct primary care (DPC) practices is going up.
From owners to employees
The decline of the physician-owned practice is a long trend, not a blip. The American Medical Association (AMA) has tracked the share of doctors in private practice falling year after year, from 60.1% in 2012 to 42.2% in 2024 [1]. The AMA points to low insurance payment, rising overhead, and administrative burden as the drivers [1]. Running an independent practice on insurance reimbursement got harder every year.
Where did those doctors go? Mostly into hospital systems and corporate-owned groups, including practices bought by private equity. The Physicians Advocacy Institute found that 77.6% of physicians were employed by hospitals or other corporate entities as of January 2024, a record high [2]. We covered the investor side of that shift in the growth of private equity in concierge medicine. Employment offered a salary, a billing department, and someone else to argue with the insurers. For many doctors it also brought higher patient volumes and less control.
Why employed medicine burns doctors out
The employed model runs on volume. A traditional primary care doctor carries a panel of 2,000 to 2,500 patients and sees them in visits that run 10 to 15 minutes. The math behind that schedule does not work. One study estimated that a primary care physician would need 26.7 hours in a day to deliver all guideline-recommended care to an average panel [3]. A day does not have 26.7 hours, so something gets cut, and the doctor absorbs the gap as unpaid evening charting.
Burnout follows. National physician burnout reached 45.2% in 2023, down from a pandemic peak of 62.8% but still well above earlier years [4]. Primary care specialties sit near the top of that range in every year they are measured [4]. The drivers stay consistent: patient volume, administrative load, and loss of autonomy. A doctor who trained to practice medicine ends up managing a queue.
What DPC changes
Direct primary care removes the insurance billing layer. Patients pay the practice a flat membership, often 50 to 200 dollars a month, and the practice bills no one else for routine care [5]. For a fuller primer, see what direct primary care is. The model changes the doctor's day in three ways.
First, the panel shrinks. DPC doctors cap their panels well below the traditional load (traditional doctors up to 2,500 patients), commonly around 600 patients and up to about 800, because they no longer need volume to cover insurance overhead. Second, visits get longer, often 30 to 60 minutes. Third, the daily pile of denials and prior authorizations mostly goes away.
The effect on the doctors who switch shows up in the survey data. In the American Academy of Family Physicians (AAFP) 2024 brief, 49% of DPC physicians reported no burnout at all, against 14% of non-DPC physicians, and 94% said they were satisfied with their practice, against 57% of their peers [5]. DPC doctors were roughly three and a half times more likely to report no burnout [5]. For a physician deciding whether to stay employed or go independent, that gap is the pitch.
The economics that let a doctor leave
A doctor does not give up a salary on principle alone. DPC works financially because it removes the staff and systems built to bill insurance, a major expense in a traditional practice. With membership revenue that arrives predictably each month, a solo doctor can run a viable practice on a few hundred members rather than a few thousand patients. We broke those numbers down in what direct primary care actually costs to run.
That is why DPC is not only a solo phenomenon. Independent groups have formed too. Antioch Med in Wichita, Kansas runs as a multi-physician DPC practice, the kind of independent group that a decade of consolidation was supposed to erase. Lower overhead is what makes the exit from corporate medicine survivable.
What DPC does not fix
The honest version of this story includes the trade-offs. DPC is not free care, and it is not a fit for everyone. Patients still need insurance for hospital stays, surgery, specialists, and emergencies, so a membership is a second cost on top of a health plan, not a replacement for one [5]. For a healthy person who rarely sees a doctor, the monthly fee can sit unused. DPC practices also do not bill Medicare, which creates specific rules for patients over 65 to understand before joining.
The model has a limit at the system level too. When a doctor caps a panel at 600 patients, the patients who do not make the cut still need care somewhere. DPC improves the experience inside one practice. It does not, on its own, add physicians to a shrinking national workforce. A doctor weighing the switch, and a patient weighing a membership, should price those trade-offs in.
Why it matters for patients
When a doctor leaves employed medicine for DPC, the patient who follows gets back the time the old system took out. The outcomes data supports the move. An actuarial study for the Society of Actuaries found that DPC patients visited the emergency room 40.51% less often than patients in traditional insurance-based care [6]. Longer visits and easier access catch problems earlier.
The shift is large enough to measure nationally. A 2025 Health Affairs study found that the number of clinicians in concierge and DPC practices grew 78.4% between 2018 and 2023 [7]. The doctors leaving corporate medicine are not a handful of outliers. They are a steady migration, and patients are following them out.
If your doctor has gone independent, or you want one who has, you can browse DPC and concierge practices by city on NextMD.
FAQ
What is direct primary care?
Direct primary care is a model where patients pay the practice a flat monthly or annual fee for primary care, with no insurance billing for routine visits [5]. Fees commonly run 50 to 200 dollars a month. Patients usually keep separate insurance for hospital care, specialists, and emergencies.
Why are doctors leaving corporate medicine?
Commonly cited reasons include administrative burden, high patient volume, short visits, and loss of autonomy, which together drive burnout [3] [4]. DPC lets a doctor cut the panel, lengthen visits, and drop insurance billing.
Are doctors happier in DPC?
The survey data points that way. In the AAFP 2024 brief, 49% of DPC physicians reported no burnout versus 14% of non-DPC physicians, and 94% were satisfied with their practice versus 57% [5].
Is direct primary care the same as concierge medicine?
They are related but not identical. DPC charges a lower flat fee and does not bill insurance. Concierge practices charge a higher membership and often still bill insurance for visits. Both shrink the panel to give the doctor more time per patient.
How do I find a doctor who left corporate medicine for DPC?
You can browse and compare DPC and concierge practices by city on nextmd.ai/search.
A Note From the Author
I am not a doctor. Nothing in this article should be considered medical advice.
This piece is a plain-language summary of publicly available physician-workforce data, peer-reviewed research, and survey findings. Practice models, fees, and panel sizes vary by clinic. Confirm details with any individual practice before making care decisions.
NextMD helps you find and compare concierge medicine and direct primary care practices across the United States. Browse practices by city, compare pricing, and find a doctor who has time for you at nextmd.ai/search.
Sources
American Medical Association. (2025). Physician Practice Benchmark Survey: Shifts in Practice Ownership and Structure (2012–2024). AMA Research. Read on AMA-ASSN.org. Referenced for the decline in physician-owned private practice from 60.1% (2012) to 42.2% (2024).
Physicians Advocacy Institute / Avalere. (2024). Hospital and Corporate Acquisition of Physician Practices and Physician Employment Trends, 2019–2023. PAI Research. Read on PhysiciansAdvocacyInstitute.org. Referenced for the 77.6% of physicians employed by hospitals or corporate entities as of January 2024.
Porter, J., Boyd, C., Skandari, M.R., & Laiteerapong, N. (2023). Revisiting the Time Needed to Provide Adult Primary Care. Journal of General Internal Medicine, 38, 147–155. Read on PubMed (PMID 35776372). Referenced for the 26.7-hours-per-day estimate to deliver guideline-recommended care.
Shanafelt, T.D., et al. (2024). Changes in Burnout and Satisfaction With Work-Life Integration in Physicians, 2011–2023. Mayo Clinic Proceedings. Read on Mayo Clinic Proceedings. Referenced for national physician burnout of 45.2% in 2023 and the 62.8% pandemic peak in 2021.
American Academy of Family Physicians. (2024). Direct Primary Care Data Brief (member survey findings). AAFP. Read on AAFP.org. Referenced for 49% of DPC physicians reporting no burnout vs 14% of non-DPC physicians, and 94% vs 57% practice satisfaction.
Busch, F., Grzeskowiak, D., & Huth, E. (2020). Direct Primary Care: Evaluating a New Model of Delivery and Financing. Society of Actuaries / Milliman. Read the full report on SOA.org. Referenced for the 40.51% emergency-room reduction among DPC patients.
Zhu, J.M., et al. (2025). Growth in Concierge and Direct Primary Care Practices and Clinicians in the United States, 2018–2023. Health Affairs. Read on Health Affairs. Referenced for the 78.4% growth in concierge and DPC clinicians between 2018 and 2023.