How corporate ownership is reshaping how physicians practice

Most employed physicians feel pressure to put their employer's priorities ahead of what they believe is best for patients, according to a new survey from the Physicians Advocacy Institute (PAI).

Healthsperien conducted the 2026 Employed Physician Survey, which polled 1,003 employed physicians in practices owned by hospitals and health systems, private equity or venture capital firms, and health insurers. It arrives as corporate ownership has become the dominant model in U.S. medicine. Of all physicians, 82% are now employed by hospitals or other corporate entities, and 63.9% of practices are corporately owned, according to PAI data compiled by Avalere Health.

The survey found that nearly half of respondents frequently feel pressure to see more patients than is optimal. About three in five face pressure to keep patients in-system or barriers to referring outside the network, and those pressures were sharpest in insurer-owned practices. Physicians also described broken equipment, missing records, appointment delays and heavy administrative burden. Prior authorization frequently delays care or leads patients to abandon treatment.

The strain shows up in physicians' career plans. Nearly nine in 10 report some level of burnout, 44% are looking for or considering a new job, and nearly half would consider joining a union. For most physicians under 40, corporate employment is the only model they have known.

PAI has long argued that corporate owners put profits ahead of patients and physicians, and the new findings add physicians' own accounts to that debate.

Here are the key findings: