Opinion: The future for practicing physicians in a corporate world
Forty years ago, in his Pulitzer Prize-winning history “The Social Transformation of American Medicine,” sociologist Paul Starr predicted that independent physician practice, which had been a cornerstone of American medicine for most of the 20th century, would be eclipsed by the “coming of the corporation.” Starr forecast that the end of the century would not only be “a time of diminishing resources and autonomy” of this powerful profession, but also “greater disunity, inequality and conflict throughout the entire health system.” With the benefit of 40 years of hindsight, Starr’s was a remarkably prescient forecast.
By 2020, for the first time, less than half of U.S. physicians worked in physician-owned settings: more than 300,000 U.S. practicing physicians were employed by hospitals, and another 122,000 were employed by corporations of various kinds — health insurers, pharmacy chains, private equity-backed companies. A single diversified health insurer, UnitedHealth Group, claims to employ or represent 60,000 physicians through its Optum Health subsidiary.
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