Private practice doctors are disappearing, and it’s not by accident

17 Feb 2026 · 1 min

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In this monologue, Dan Novaes explains how U.S. hospitals are systematically buying out private medical practices, turning formerly independent doctors into hospital‑affiliated providers. He describes the financial mechanics: hospitals acquire the practice, retain the physician, and then bill the same appointment as a hospital facility service, inflating the cost from roughly $100 to $500. Insurance companies reimburse hospitals at higher rates, allowing hospitals to capture the difference while patients receive larger bills. Novaes argues that this model erodes doctors’ independence and reduces their earnings, while the high overhead of running a private practice makes it untenable. The consolidation creates a few massive hospital systems that dominate the market, eliminate competition, and drive up prices. He frames the situation as a legal monopoly sustained by hospital lobbying, resulting in a system that extracts maximum money from sick patients and benefits hospital profit margins.

Chapters

Private practice. Doctors are disappearing. Hospitals are buying them out. Why? Control and profit. Hospitals buy the practice, keep the doctor, then charge facility fees. The same appointment that cost $100 now costs 500 because it's at a hospital facility. Insurance pays more to hospitals. Hospitals exploit this. Patients get massive bills. Doctors lose independence, get paid less. But running a private practice is too expensive now. Healthcare consolidates. A few giant hospital systems control everything. Competition disappears, prices rise. This is monopol of healthcare, and it's legal. Hospitals lobby to keep it this way. Patients pay more, doctors make less, hospitals profit. The system extracts maximum money from sick people and it's getting worse.