The "Quiet Crisis" of the Physician Practice

Last week, I read a post on LinkedIn by a prominent pediatric surgeon. The surgeon voiced passionate concerns about A Quiet Crisis Getting Louder.

A crisis in the loss of physician autonomy, regulations, and a retreat from independence to on-the-clock employment.

His passion resonated with me.

But first, a story of the solo pediatrician behind the drugstore

Bear with me. I remember my mother taking my siblings to see "Dr. Diamond." His office was tucked away behind a drugstore on 111th Street in Chicago. We all sat in his waiting room, dreading the shots we were sure we'd get.

For young Dr. Diamond, it started his journey from practicing behind a shabby drugstore to the chairman of Pediatrics at Loyola University Stritch School of Medicine and a visiting professor at Rush Medical College. Then, Loyola's Outstanding Clinical Teacher Award, Sertoma Chicago's Man of the Year, and the Illinois Academy of Pediatrics' Pediatrician of the Year. In addition to his medical practice, Dr. Diamond became a prolific author, with many books on pediatric care and medical ethics - some still relevant today.

Of course, I only discovered his full story many years later via Google. How did the doctor, who seemed "kinda stern" with his scary shots and strict advice to my mom, go so far down the path to greatness?

The answer? He had nearly unlimited autonomy and a unique opportunity to practice, learn, and gather insight and evidence as his practice grew. It was his choice to evolve and continuously expand his career path.

Today, our healthcare system has changed. Dramatically.

The Quiet Crisis Post

The surgeon spoke of the daily threats and challenges private practices face. Like many, his unwavering belief is that private practice is the cornerstone of personalized and community-based care. He speaks of the existential threat when physicians are pushed toward employed positions due to complex regulations, payer demands, and a near-complete eroding of autonomy.

In particular, the forces that vacuum up autonomy also reduce or remove patient choice. The vast health systems compete with private practice, and the new wave of payers who want to be "providers" compete with health systems and physician practices.

Our pediatric surgeon noted that regulatory capture occurs when large hospital systems, insurers, and government entities shape policies to serve their interests, consolidating power while disadvantaging independent practices. Similar trends are observed in banking and other industries, resulting in reduced competition and diminished control for smaller players.

The result? A loss of what makes healthcare personal and human.

The Quiet Crisis Deserves a Clear Solution

You’re not imagining it. Private practice, once the cornerstone of personalized, community-based care, is being squeezed out—not by natural market forces but by the calculated hand of regulatory capture.

It’s exhausting—the constant fight against rising administrative burdens, the dwindling reimbursements that barely cover overhead, and the consolidation of power that leaves independent physicians out of the conversation.

But here’s the truth: it doesn’t have to end this way.

What If Private Practice Could Fight Back?

Chronic Disease Management (CDM) and Clinical Care Management (CCM) might sound like just another layer of complexity, but for independent physicians, these solutions could be precisely what they need to regain revenue, patient relationships, and autonomy.

When combined with third-party support, these models offer real opportunities to address the challenges driving physicians out of private practice.

CDM CMM and the Private Practice

Administrative and Regulatory Relief

The paperwork mountain—billing codes, preauthorizations, compliance—crushes private practices. Third-party staffing solutions can take on these tasks, freeing physicians to do what they were trained to do: care for patients.

Financial Viability

Declining fees don’t have to mean the end of independence. CDM and CCM programs create new revenue streams through CMS reimbursements for chronic care services like telehealth. These programs also reduce costly hospitalizations, benefiting practices and patients alike.

Rebuilding Relationships

Consolidation strips away the human element. Armed with personalized chronic care programs, independent practices can offer relationship-driven care that fosters trust and improves outcomes.

Restoring Bargaining Power

Hospitals and insurers may dominate, but practices leveraging data from CDM and CCM programs can negotiate better contracts or join independent practice associations to level the playing field.

Advocating for Policy Change

We’ve seen the results of regulatory capture. Imagine real-world examples of independent practices thriving under CDM and CCM models. These success stories could push policymakers to prioritize equity over consolidation.

It’s Time to Protect What Makes Healthcare Human

Private practice isn’t just about business—it’s about preserving the patient-physician relationship that forms the heart of care. But we can’t just watch the machine grow.

Physicians must embrace models that work for them, challenge policies that favor monopolies, and educate patients on the impact of regulatory capture.

Change starts with bold steps that allow private practices to thrive, not just survive.

Let’s rewrite this narrative together.

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