11 practice models physicians are using to take back control of the business

Concierge and direct primary care practice sites grew from 1,658 to 3,036 between 2018 and 2023, an 83.1% increase, and the number of clinicians working in them rose 78.4%, according to a study published in Health Affairs in December 2025. The authors tied that interest to smaller patient panels and greater clinical autonomy than traditional primary care offers.

In 2024, 42.2% of physicians worked in practices wholly owned by physicians, down from 60.1% in 2012, the American Medical Association reported from its Physician Practice Benchmark Survey. Hospital-owned practices accounted for 34.5%, up from 23.4% over the same period.

Direct primary care is the model named most often in that conversation, and it enters 2026 with a federal tax advantage it did not previously have.

These models answer the same question, albeit in different ways: Who pays you, and what do you give up to change that? Four models change how revenue reaches the practice. Two buy scale without an equity sale. Two swap the patient for an employer or a federal agency as payer. Three change where and when the work happens. None of them removes the pressures that sent physicians looking.