Historically, in the 2000s, 2/3 of medical practices were physician-owned and hospitals owned the rest. More recently, physicians are rapidly abandoning private practice so that at this time about ½ are owned by doctors. Why?
Well, start with the Affordable Care Act with its thousands of pages of regulations, a bureaucratic nightmare. Doctors spend more and more time (as much as 15 hours a week) on paperwork. EMRs (Electronic Medical Records) added a whole new level of complications and to this date have not worked.
Add the fact that private practitioners are paid less by Medicare than the hospitals providing the same service, as much as 40% more!!
Centralization to hospitals limits access to care so sick people go to the emergency room because appointments are too difficult to make and are often weeks away. Healthcare costs increase markedly using emergency services. In private practice, doctors depend on the number of patients they see for their income stream. Working for a hospital, they are paid the same no matter how few or many patients they see. De-incentivized for sure.
One of the objectives from the health reform project in 2010 (Obama care), stated that the plan would accelerate physician employment by hospitals and create larger physician groups. It worked!! Affordable? What kind of lobby created that? Hmm.