The Future of US Healthcare: Why Private Practices Matter

The following is a guest article by Victor Zhou, Founder and CEO at Klarity Health

In an era of unprecedented business consolidation within American healthcare, we find ourselves at a critical juncture where the shifting economic structure of the industry is threatening the integrity of healthcare, which, at its heart, is preserving human-centered, relationship-driven care that drew many practitioners to medicine in the first place.

The sacred bond between physician and patient, which has been the foundation of healing despite all our technological advances, is now at risk. We must confront a sobering reality: the independent practice model—the backbone of American medicine—stands at risk of extinction if no one takes action. 

A Battle Against Unchecked Corporate Consolidation

Healthcare is not evolving with the massive-scale corporate consolidation; it’s being absorbed. The unchecked consolidation is accelerating, eroding independent practice and shifting medical decisions from clinics to boardrooms. The shift is not merely a change in business structure—it represents a fundamental reshaping of how medical decisions are made, how care is delivered, and who ultimately controls the patient-provider relationship.

UnitedHealth Group’s strategic maneuver through its Optum subsidiary dramatically illustrated this trend when it purchased DaVita Medical Group for $4.9 billion in 2018. This single acquisition encompassed over 300 clinics and more than 2,300 employed or affiliated physicians. The broader context is even more alarming: according to the Physicians Advocacy Institute’s comprehensive report, physician employment by hospitals and corporate entities surged by 86% between 2012 and 2022, causing independent practices to plummet from 60.2% to just 30.4% of the market. This systematic absorption has tangible consequences, with independent practices experiencing an estimated 25–30% revenue decline, effectively squeezing out smaller medical providers and fundamentally reshaping the healthcare delivery ecosystem.

On the bright side, the Department of Justice (DOJ) has emerged as a critical guardian against healthcare monopolization, systematically challenging massive corporate consolidations that threaten market competition and patient care. Recent interventions–like blocking UnitedHealth Group’s attempted acquisition of Change Healthcare, challenging coordinated pricing strategies through Medicare Advantage antitrust investigations, and supporting the FTC’s challenge to the Illumina-GRAIL merger—have all revealed a profound governmental stance: healthcare is not merely a market commodity, but a critical ecosystem where patient interests must supersede corporate profit motives. The DOJ is defending a healthcare model that prioritizes innovation, affordability, and patient-centric care over corporate expansion–but one federal agency alone cannot take on the entire system. Providers across the healthcare landscape, both upstream and downstream, must rally in support of this effort.

The Private Practice Mission: Prioritizing Patient Centered Care

Independent Provider Preserves the Integrity of the Medical System

Healthcare is built on trust, not just throughput. Independent practices play a critical role in preserving the provider–patient relationship, a dynamic that can be easily strained in systems driven by volume metrics and standardized protocols. Detached from convoluted corporate interference, physicians are better positioned, with autonomy and space, to deliver care that is personal and grounded in integrity.

One psychiatric provider, for example, routinely gives cash-pay patients an extra week to cover their sessions until their next paycheck arrives, knowing that medication management can’t wait. This kind of care is only possible when providers have the autonomy to set their own terms–a freedom rapidly disappearing under corporate ownership. As one clinician put it, medicine is here to help people, not just make money. Private practice preserves that principle by allowing doctors to act on it. It remains one of the few places in healthcare where providers and patients are aligned in seeking more affordable costs, yet personal care. Unlike large institutions with opaque and inflexible pricing, private providers often operate with financial empathy, offering grace periods, setting affordable rates, and prioritizing treatment over transactions. This isn’t about charity; it’s about preserving the integrity of a system increasingly driven by profit.

Patient Care is Human Relationship Building, Not a Transaction

Care quality isn’t just about the visit–it’s about what happens between visits. Imagine having your doctor in your text messages, checking in daily to ensure your medication is working, tracking your symptoms, and helping you course-correct in real time. That’s what real human care looks like: frequent, attentive, and responsive. It’s not a portal message buried in a backlog or a nurse line with a 72-hour delay. It’s a relationship.

When we opened up channels for doctors to do aftercare follow-ups at Klarity, a simple text reminder reduced the no-show rate by 40%. Text interaction with a human touch can strengthen doctor-patient relationships more than people realize. And that kind of relationship isn’t possible in high-volume, bureaucratic systems designed to maximize throughput. It’s only in private practice, where providers control their time, their workflows, and their priorities, that this level of personal, continuous care can exist.

The Autonomy Better Incentivizes Private Practices to Provide Sustainable Care 

Rigid corporate structure is driving the burnout epidemic among healthcare professionals. Large systems, such as Kaiser Permanente, have experienced strikes and workforce attrition because they operate under intense administrative overhead. Physicians spend more time charting and responding to internal metrics than practicing medicine. In these environments, care becomes transactional, and providers are forced into productivity quotas rather than meaningful patient interaction. 

In contrast, in an environment where private practitioners control their own business, autonomy protects them from the worst of bureaucratic burnout and helps them navigate stress, better incentivizing them to cope with it while prioritizing sustainability over short-term profits. The difference isn’t just about workload–it’s about whether that work aligns with why they became doctors in the first place.

AI in Healthcare: A Competitive Advantage for Private Practice

Private practice, with its agility and proximity to patients, is uniquely positioned to leverage emerging technologies like AI as a competitive advantage. These technologies will play a transformative role in the future of medicine and independent practices are more nimble than large healthcare systems constrained by legacy infrastructure and approval hierarchies.

This adaptive advantage could level the playing field against corporate giants—but only with thoughtful implementation. The challenge is that current AI tools are built to streamline isolated tasks rather than support the full care workflow. A note-taking assistant might transcribe a visit efficiently, but it won’t input prescriptions, manage lab orders, or navigate outdated EHRs. Without true end-to-end solutions, AI risks becoming just another layer of friction rather than the force multiplier it promises to be.

The other critical factor is provider education. Learning how to integrate AI into daily practice isn’t like learning a new drug; it requires redesigning clinical workflows and developing new skills. Many providers—already stretched thin—need structured training, conferences, and peer communities to effectively incorporate these fast-evolving tools into their practice.

With the right implementation strategy and proper training, AI represents one of the biggest opportunities for small practices to enhance their efficiency, improve patient outcomes, and maintain independence in an increasingly consolidated landscape. By embracing these tools thoughtfully, private practitioners can offer the personalized care that defines their practice model while leveraging technology to expand their capabilities and reach.

Conclusion: Preserving the Future Through Independent Care

The future of American healthcare depends on more than innovation or investment. It depends on preserving the clinical autonomy, patient relationships, and ethical grounding that private practices uniquely protect. As consolidation accelerates, the risk is not just economic—it is existential. The erosion of independent practice threatens to sever the human connection at the core of medicine and replace it with volume-driven, profit-maximized care.

Private practices remain one of the last safeguards against this shift. Their agility, integrity, and alignment with patient interests make them essential to a sustainable healthcare ecosystem. With strategic use of technology, renewed institutional support, and a collective pushback against unchecked consolidation, independent providers can reclaim their role, not just as caregivers, but as stewards of a system that values care over commerce.

Now is the time to act—not to preserve tradition, but to protect the future of care itself.