The Private Practice Resurgence: Why Physicians Are Staying Independent in 2026

For the last 15 years, the narrative was clear: private practice was dying. Consolidation was inevitable. Independent practices would either be acquired by private-equity-backed platforms or absorbed by hospital systems. The only question was when.

That narrative is breaking down.

The AMA's Physician Practice Benchmark Survey has tracked a long-term decline in the share of physicians in private practice. At the same time, anecdotal and market signals point to renewed interest in independence in specific pockets: physicians who sold to PE-backed platforms exploring buybacks, and smaller groups actively resisting acquisition. The broader consolidation trend has not reversed, but the appetite for independence among some physicians appears to be strengthening.

This isn't nostalgia. It's economics.

Why the Narrative Changed

The PE acquisition wave of 2015-2020 was built on a simple theory: consolidation creates efficiency, efficiency creates margin, and margin creates returns. The theory had merit. Consolidation does create some efficiencies. But it also creates costs that PE models didn't fully account for.

When a PE firm acquires a practice, they typically implement standardized systems, centralized management, and aggressive revenue targets. On paper, this looks like optimization. In reality, it often feels like loss of autonomy to the physicians and staff who built the practice in the first place.

Physician burnout, staff turnover, and patient dissatisfaction are commonly cited concerns in discussions of PE-backed consolidation. Bain & Company's healthcare private equity research has highlighted physician satisfaction as a factor that shapes outcomes in physician-owned versus PE-backed models. The organizations that perform best tend to be the ones that give physicians autonomy within a framework of operational discipline, whether independent or affiliated.

What This Means for Your Practice

If you're independent, renewed interest in independence creates opportunity. For many practices, the question is no longer "should you stay independent?" but "how do you stay independent well?" That's a different question, and it has an answer.

The practices most likely to thrive over the next decade are the ones that choose independence intentionally and build the operational foundation to sustain it.

---

Sources

• American Medical Association, "Physician Practice Benchmark Survey," ama-assn.org
• Bain & Company, "Global Healthcare Private Equity and M&A Report," bain.com

All third-party names and trademarks are the property of their respective owners. References do not imply affiliation or endorsement.

What the current data shows

The case for staying independent is not sentiment. The acquisition market itself has cooled on physician groups.

• Physician groups fell from 28% of global private equity provider deal value in 2021 to 23% in 2025, per Bain & Company, which attributes the shift to labor shortages and reimbursement pressure. Overall healthcare private equity value hit a record in 2025, so the money did not leave the sector. It moved away from practices.
• Healthcare services deal count dropped 18.5% year over year in the second quarter of 2026, per PitchBook, with physician practice management lagging the rest of the sector under higher borrowing costs and regulatory scrutiny.
• 43.5% of announced 2025 hospital and health system transactions involved a distressed party, per VMG Health. The institutions that once looked like a safe harbor are consolidating out of pressure rather than strength.
• At the same time, the Physicians Advocacy Institute and Avalere Health count 82% of physicians as employed as of January 2026, so the long-run trend has not reversed.

The honest reading: independence is not winning by default, and the exit is no longer the easy answer it looked like in 2021. Owners with clean operating economics have more room than they did five years ago.