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​​​​​THE TRUSTEE 

 March 2026
Vol XIX, No. 187

Rethinking Corporate-owned Medical Practices

Why have some doctors who opted for hospital/ medical  corporate employment now regretting their loss of a personal private practice?

In recent years, the "pendulum" of physician employment has begun to swing back. While many doctors initially joined large hospital groups to escape the financial risks and administrative headaches of running a small business, a significant number now express "buyer’s remorse."

As of 2026, the regret stems from a fundamental shift in the doctor's role: moving from a professional leader to a corporate unit of production.

The Erosion of Clinical Autonomy

In private practice, a doctor is the "captain of the ship." In a hospital/ medical group, they are an employee subject to corporate oversight.

• Referral Restrictions: Many hospital systems require doctors to refer patients only to specialists within the same network, even if an outside specialist is a better fit for the patient.
  
• Treatment Interference: Doctors report being pressured to adjust treatment plans or choose certain medications based on hospital-wide cost-saving incentives or preferred vendor contracts.
  
• The "Five-Minute" Visit: Hospital systems often prioritize "throughput." Physicians who used to spend 30 minutes with a complex patient now find their schedules packed with 10-to-15-minute slots to meet "productivity" quotas.
  

High Burnout and "Moral Injury"

While hospital employment was supposed to improve work-life balance, data shows the opposite for many.

• Documentation Burden: Even with administrative support, hospital-employed doctors often spend up to 60% of their day on Electronic Health Records (EHR) to ensure the hospital can bill at maximum rates.
  
• Moral Injury: This is the psychological distress felt when systemic barriers (like cost-cutting or staffing shortages) prevent a doctor from providing the quality of care they know a patient needs.
  
• The Stats: Recent surveys indicate burnout rates as high as 62% among hospital-employed physicians, compared to as low as 13.5% in some small, independent practices where doctors feel more in control of their environment.
  

 The Financial "Ceiling"

Initially, a hospital salary looks attractive because it is guaranteed. Over time, however, the financial math often favors the private owner.

• Production Bonuses: Many hospital contracts use Relative Value Units (RVUs) to calculate pay. If the hospital increases its overhead or changes the formula, a doctor may work harder for the same or less pay.
  
• Loss of Ancillary Income: Private practice owners can earn extra revenue through laboratory services, imaging (X-rays/MRIs), and surgery center ownership. Hospital and corporate employees lose these lucrative streams entirely.
  
• Non-Compete Clauses: Many doctors feel "trapped" because their contracts contain aggressive non-compete clauses, preventing them from opening a nearby practice if they decide to leave the hospital.
  

The "Renaissance" of Independence

Because of these regrets, 2026 is seeing a rise in "Micro-Practices" and "Direct Primary Care" models. These allow doctors to return to private practice by using AI-driven administrative tools to keep overhead low, allowing them to focus almost entirely on patient care without the corporate middleman.

Adapted from NIH.gov, HHS.gov, PAI.org, medicaleconomics.com
 

Important Reminder for all Members – Changes in Status

 It is imperative to notify the Trust Office of any status changes (marriage, divorce, legal separation, births, deaths, dependents, dependent age 26, address, child custody, disability, active/retired), and any condition affecting special programs, such as diabetes, prenatal, infertility, and weight loss. Failure to do so can be costly to the member and may even result in loss of benefits. Please send updated information to enrollment@ktftrustfund.com  or call the Trust office at 844-583-3863.

 
Member Reimbursement

Are you unsure or confused about submitting for member reimbursement? Several members have inquired about the process. Instructions for  filing, including how to  complete the form for Member reimbursements for out-of-network services can be found on our website at www.ktftrustfund.com. Once completed, reimbursement forms for  doctor visits/ treatments, medical massage, and vision care should be sent to MAGNACARE at PO Box 5085, Garden City, NY 11530. (This address is for member reimbursement use only, not providers.) Completed gym reimbursement forms should be sent to appeals@ktftrustfund.com.

All forms must be completed to be processed. Please be sure the forms are legible and that contact information is complete and correct. Members will be contacted if there are problems as long as contact information is provided. If you have a question or need additional help,  please reach out to the KTF compliance office at 844-583-3863.

Travel Insurance

As Spring break and the travel season approaches, everyone is reminded to get travel insurance if you are traveling outside of the continental United States. International Travel insurance is relatively inexpensive and can save you thousands of dollars in the event you have a medical issue while traveling. Your Trust insurance will cover you, but if your costs exceed what the plan pays, you will be responsible for all the additional costs. The Trust has no control over out of network or out of country costs. Travel Insurance is a worthwhile investment for your trip! You can get travel insurance which includes health coverage and trip protection inexpensively through several companies. One that several members have used is InsureMyTrip.com.