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The Future of Physician Work: From Corporate to Direct Care
Huddle #Trends
Jared Dashevsky, MD
April 06, 2025 • Estimated Reading Time: 10 minutes
HUDDLE #TRENDS
The Future of Physician Work: From Corporate to Direct Care
Will physicians reclaim their autonomy, rewrite the playbook, and finally break free from administrative bloat?
I believe they will—and sooner than most expect. Over the next two decades, we could see a fundamental shift in how care is delivered. The catalyst? A growing movement toward direct care models and a deliberate step away from insurance dependency—except in cases of true medical catastrophe.
In this Huddle #Trends report, I’ll walk through the rise of corporatized healthcare, how it reshaped physician employment, and why we’re now seeing early signs of a course correction. I’ll end with a look at direct care models—including one I could see working in my own (future) pulmonary practice—and what they might mean for the future of medicine.
First, Some History of Physician Employment
In the early 20th century, most physicians ran solo practices and knew every patient by name—often by knocking on their door.
Can you believe that?
House calls were the norm. A black bag, a stethoscope, and deep community roots—that was healthcare. It was personal, local, and relationship-driven.
Fast forward to the 1970s and 80s, and we saw the rise of Health Maintenance Organizations (HMOs). These introduced a more structured, cost-conscious approach. Efficiency and prevention became buzzwords. Physicians began joining group practices, drawn in by shared overhead, collaboration, and the promise of fewer administrative headaches.
Then came the 1990s and early 2000s—the era of Physician Practice Management Companies (PPMCs). Think of them as the first wave of corporatization, long before private equity entered the scene. These companies promised doctors administrative support and economies of scale. But many collapsed under the weight of poor execution and financial mismanagement.
At the same time, hospital employment gained steam. Stable salaries. Benefits. Work-life balance. It was a tempting offer—and many doctors took it.
But with that shift, something else changed: the physician’s role evolved from owner to employee. Independence gave way to hierarchy. And the stage was set for the corporate healthcare landscape we live in today.
Physician Employment Trends (and What’s Driving Them)
Most physicians today don’t own their practices.
In fact, nearly 80% of U.S. physicians are now employed—either by hospitals, health systems, or corporate entities like insurers, private equity firms, or even retailers. And that number has jumped 25% since 2019.
Source: PAI-Avalere Report on Physician Employment Trends and Acquisitions of Medical Practices: 2019-2023
When I read that, I see the ripple effects on autonomy, decision-making, and burnout. You probably do, too.
So what’s really driving this shift? …
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