Not long ago, owning a piece of a medical practice was the ultimate marker of professional success for a physician. Today, that’s hardly the case. The healthcare landscape is dominated by corporate buyouts, private equity firms, and large hospital systems, and the traditional model of physician ownership has been pushed to the sidelines.
At this point, you may be questioning whether equity ownership is still a worthy goal or whether that dream is an outdated ideal in a system that favors employment.
This guest post will explore that question, with insights from Sermo’s verified physician members, including comments and poll results from more than 500 doctors. Sermo members can access full poll results and member commentary here. Sermo is a private community where doctors share perspectives, discuss clinical trends with peers, and earn via paid medical surveys. Sermo members’ firsthand experiences paint a clear picture of the evolving sentiment around equity.
Take one doctor’s perspective.
“Owning part of your practice used to be the big goal—freedom, control, and a real say in how things were run,” they wrote on Sermo. “Now, with so many hospitals and big groups taking over, that dream feels harder to reach. Still, there’s something appealing about having skin in the game instead of just being an employee.”
An oncologist reflected on what the shift means for physicians.
“The decline in physicians holding equity stakes reflects a gradual loss of professional autonomy and clinical decision-making power,” they argued. “While ownership once symbolized independence and stability, many doctors now prioritize the job security and work-life balance that come with hospital employment. The key question is whether the future of medicine will allow a hybrid model that combines professional independence with economic sustainability.”
Here’s how this central tension—a desire for independence clashing with the realities of modern medicine—is evolving.
Who Still Owns a Piece of the Practice?
To understand the current state of physician ownership, Sermo polled its physician-only community. When asked whether they have an ownership or equity stake in a business, physicians were split—25% said they are a full or partial owner of their practice, 9% said their equity is in another healthcare-related business, and 37% said no but that they’d be interested in ownership opportunities. This suggests the dream of ownership is far from dead, even if its accessibility has diminished.
This was also the case when physicians were asked about physician ownership trends among their peers, as 52% believe that physician practice ownership is decreasing, 22% see it as increasing, and 20% think it’s staying the same.
The data mirrors broader industry trends. The American Medical Association (AMA) reports that the share of physicians working in private practice fell to 42.2% in 2024, a fall from the 60.1% in private practice reported in 2012. The significant drop over a decade highlights a generational shift in attitudes. Consolidation under hospital systems and buyouts by private equity firms are shrinking the number of independent practices available for physicians to join or acquire.
“The vast majority of private practices in my area have been snatched up by hospital systems and insurance companies,” one general practitioner revealed on Sermo.
Some physicians still see value in retaining a stake.
“In our business model, I remain a partner, albeit with a small interest in the practice,” an internist shared. “I think this is important to have more skin in the game.”
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The Benefits of Physician Ownership
Despite the hurdles, some physicians still find ownership alluring. When Sermo asked physician-owners about the biggest benefit of holding equity, their answers pointed toward financial gain and professional freedom.
Higher earning potential was a big benefit, with 36% of respondents citing it. While an employed salary offers predictability, equity provides the opportunity for significant long-term wealth creation. A 2025 study analyzing data from the US Census Bureau’s Statistics of US Businesses found that over the preceding two decades, non-surgical physicians in private practice made 35% more compared to those working in hospitals.
However, the return on investment (ROI) is not guaranteed. Buying into a practice requires substantial capital and carries inherent risks. Some physicians might achieve similar or better financial outcomes by investing in traditional assets like index funds or real estate, without the added administrative burden of running a practice.
But ownership is about more than just money. Nearly half of the Sermo poll respondents (45%) pointed to non-financial benefits like clinical autonomy and the ability to shape practice culture. For these physicians, equity is a means to practice medicine on their own terms.
The definition of “equity” is also expanding. With fewer traditional private practices available, physicians are finding alternative paths. These include investing in ambulatory surgery centers (ASCs), telehealth startups, medical technology companies, and other non-clinical healthcare ventures. This allows doctors to leverage their medical expertise for financial growth while maintaining a degree of independence.
How Physicians Become Owners Today
The journey to ownership has changed over the years, and Sermo’s poll data shows how physicians are acquiring equity today. Of the physicians who have held equity, founding a practice remains the most common path (20%). However, buying into an existing group (15%) or receiving equity as part of a partnership track (10%) are also significant pathways. The fact that more than half of all respondents (54%) have never had an ownership stake underscores the structural barriers that now exist.
In some cases, physicians might not meet the high buy-in costs for partnership, and the consolidation of practices means that physicians have fewer doors on which to knock. Some physicians find the trade-offs worthwhile.
“Last winter, I bought myself into the practice I've been working for for a few years,” a Sermo member said. “It brings me stress, administrative tasks, and more problems to fix. But it also brings me flexibility, a better work-family balance, a better income, [and] influence in the team and the way the practice is organized.”
Barriers to Physician Ownership
The path to equity is fraught with obstacles that deter many physicians. These barriers can be grouped into four main categories:
Financial Hurdles
The cost of buying into a practice is a primary deterrent. Many early-career physicians are already burdened with substantial student loan debt, making it difficult to secure the additional capital needed for a buy-in. The financial risk is significant, and the return is not always guaranteed.
Structural Changes
As mentioned, the consolidation of the healthcare market is the largest structural barrier. With hospitals, health systems, and private equity firms acquiring independent practices, the pool of ownership opportunities is shrinking.
Administrative and Legal Complexity
Physicians must navigate a maze of compliance regulations, billing codes, and administrative tasks to run a medical practice. The complexity and associated costs can be overwhelming, diverting a physician’s focus from patient care.
“I do not have enough [financial] knowledge to own, but I also prefer public health, which reinforces equity of access for all patients,” a cardiologist wrote on Sermo.
Cultural Shifts
There is a growing preference among younger physicians for stability, predictable hours, and a healthy work-life balance. While the employed model can still lead to burnout, it lacks the burdens of ownership.
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Is Equity Still the Goal?
The answer is no longer a simple yes or no. For some, ownership remains the ultimate aspiration—a way to achieve true autonomy and financial freedom.
“It's about having the freedom to practice medicine the way I believe in, focused on the patient, without an administrator or an investment fund that has never seen a patient in their life dictating how my work should be done,” a general practitioner said. Another doctor concluded that “equity should always remain the goal—not as an outdated ideal, but as the foundation of trust and sustainability in medicine.”
For others, independence lies not only in owning a practice but also in owning their time, achieving financial literacy, and building diverse income streams outside of traditional clinical medicine. The goal is evolving from owning a business to owning one’s career trajectory.
The decline in physician ownership has implications for the future of healthcare.
As a nephrologist said, “If equity disappears completely, we risk losing physician-led decision-making and patient-centered care.”
Ultimately, ownership is not dead, but it is being redefined. While the traditional model may be fading, the underlying drive for autonomy and financial security persists. The challenge for today’s physicians is to find new and creative ways to achieve these goals, whether through a partial stake in a large group, an investment in a health-tech startup, or by forgoing ownership but building a career that prioritizes their well-being.
What do you think? Do you believe equity should still be the goal? Do you own all or part of your practice? If not, is that what you eventually want? Or would you rather be an employee?