The question of whether private practice doctors are “better” is complex, depending on a patient’s priorities regarding care, convenience, and cost. Healthcare in the United States is rapidly consolidating, blurring the traditional lines between private and employed physicians. Many smaller practices have been acquired by larger systems, meaning a doctor in a small clinic might still be an employee of a vast hospital network. This shift affects the patient experience, physician autonomy, and the overall accessibility of care.
Defining Independent Practice
Independent practice, often called private practice, is defined by physician ownership and control over business operations. This model includes solo practitioners, small group practices, and direct primary care (DPC) models where physicians are self-employed or partners in a physician-owned entity. Although the percentage of physicians in independent practices has declined due to consolidation, many doctors still work in these settings.
In contrast, employed physicians work directly for large entities such as hospitals, integrated health systems, or corporate-owned clinics. These corporate clinics standardize operational protocols and use centralized administrative systems for scheduling and electronic health records. The employment status dictates the physician’s relationship with the organization, impacting administrative duties and control over clinical decisions.
The Patient Experience Difference
A frequently cited benefit of independent practice is the emphasis on a personalized patient experience. In smaller settings, physicians often manage a smaller patient panel, allowing for more time spent with each individual. Patients of independent physicians report higher satisfaction rates, partly due to the stronger doctor-patient relationship and a greater sense of trust.
Independent physicians typically spend more time per patient visit, averaging 18.5 minutes compared to 13.3 minutes in hospital-owned practices. This increased time facilitates a deeper understanding of the patient’s history and preferences, supporting continuous and better coordinated care. Patients in corporate settings, however, often report advantages in speed, such as faster scheduling and quicker exams, appealing to those prioritizing efficiency.
The smaller scale of private practices also reduces administrative bureaucracy, simplifying tasks like appointment scheduling and prescription refills. Patients often feel more valued and less like a “number,” which contributes to overall loyalty. The ability to communicate directly with the doctor or a small, familiar staff further enhances personalized attention.
Clinical Autonomy and Treatment Decisions
A key distinction between practice models is the degree of physician autonomy, which influences treatment decisions. Independent physicians generally have full control over their practice management and clinical protocols. This freedom allows them to choose treatment paths based purely on clinical judgment and patient need, without the pressure of corporate-mandated quotas or standardized system protocols.
Independent physicians also maintain greater flexibility in their referral patterns, not being restricted to referring patients only within a specific hospital or health system network. This allows them to select specialists based on perceived quality or patient preference, rather than administrative or financial incentives of a parent organization. Employed physicians often report having less control over their daily schedule, time spent with patients, and limited autonomy in making referrals outside their employer’s network.
The organizational structure in large systems can impose limitations, with non-physician administrators often making decisions about staffing and patient flow. This lack of control has led some employed physicians to report reduced quality of care and many express a desire to switch to independent practice for greater control. The ability of private practices to swiftly adopt new technologies and care models, such as telehealth, also demonstrates a flexibility that larger, more bureaucratic systems often lack.
Cost and Accessibility Considerations
The financial aspects of private practice present a mixed picture for patients, involving trade-offs between cost savings and insurance acceptance. Independent practices often operate with lower administrative overhead compared to large hospital systems, which translates into lower costs for certain procedures. Procedures performed in independent practices may cost 30% to 40% less than the same services in hospital-owned settings.
Accessibility is a major factor, as large hospital systems generally accept a wider array of insurance plans due to their extensive contracts. Some private practices, particularly those utilizing direct primary care (DPC) models, may not accept traditional insurance, instead charging a monthly or annual membership fee. This model offers highly personalized care and greater access to the physician but requires out-of-pocket payments that may not be feasible for all patients.
Private practices frequently offer easier scheduling and shorter wait times for patients seeking immediate appointments due to smaller patient volume and less complex bureaucratic processes. While public and corporate systems aim for universal access, they can be characterized by longer wait times for non-urgent appointments. Ultimately, the best choice depends on a patient’s ability to pay, their insurance coverage, and their tolerance for wait times versus the desire for a personalized experience.