In the early 1980s, Sociologist Paul Starr published a book that predicted the future of the American healthcare system. Today, his projections have seemingly proved prophetic. Entitled “The Social Transformation of American Medicine,” Starr foresaw that the independent physician practice would eventually be overshadowed by corporate America. He predicted the “diminishing resources and autonomy” of the healthcare profession. Moreover, he proposed that inequality and conflict would engulf the entire healthcare sector.

Fast forward to the present day, many practicing physicians are no longer employees of physician-run companies and independent practices. In fact, more than 300,000 doctors have accepted employment with big corporations like hospitals, pharmacy chains, and health insurance companies.  

However, while many of Starr’s predictions remain highly accurate, there are a few additional factors that have contributed to the diminishing independent physician practice. First, we must consider the aging of baby boomer physicians. As retirement looms around the corner, many boomers have migrated to healthcare settings that offer income security and favorable work schedules. They prefer this approach over the autonomy that an independent practice offers. Next, we must consider the influx of women physicians that have entered the workforce in recent years. They prefer options that offer them greater work-life balance so they can both earn an income and make time to spend with their families, and many corporate healthcare companies obviously check this box.

It isn’t only older physicians that see the benefits of corporate healthcare. Young graduates, who are flooded with student loans, see an independent practice as being too risky. This goes back to the income security that baby boomers look for. By accepting employment, physicians of all ages have shifted the risk to enterprises. 

As a result, physicians now inadvertently support corporate agendas that are fueled by cash flow instead of patient outcomes. This includes increased admissions, imaging, surgical procedures, and prescriptions.

The current situation shouldn’t be seen as perpetual, however. Baby boomers will soon exit the workforce (mostly by medical necessity or retirement), and young physicians will eventually reduce their debts. The latter will have a choice between corporate healthcare and organizing their own independent practice. Many will be better positioned to take the autonomous approach for more freedom.

As baby boomers exit, physician shortages will result across the board giving young physicians even more flexibility.

Given the current situation in healthcare, it’s essential we consider some questions pertaining to its future. Will physicians continue to support the current culture that favors profitability over patient outcomes? Is it just a matter of time before practicing physicians begin to voice their opposition to the current healthcare structure? Or will they continue to push forward with a culture primarily focused on reducing expenses?

In medical school, healthcare professionals learn under a standard meant always to put patients first. It’s essential that they put their values first and put patients first if they want the healthcare industry to flourish. Their earning potential and opportunities will increase as patients become more satisfied with the care they receive. Right now, there’s a huge lack of trust in the industry. Patients see how corporations are impacting healthcare.

It’s up to physicians to determine the direction that their future goes as well as the future of the industry. When boomers exit and young professionals begin considering their options, it will be up to employed physicians to identify who deserves their expertise and who does not. It’s likely that these professionals will choose to take their economic power back, but only time will tell. Whatever the outcome, the next ten years will prove to be a period of transition and transformation for the entire healthcare sector.

By Colton Miller and Chris David