As consolidation’s continued effect on traditional healthcare ownership models sweeps the industry, it seems independent practices that were once the standard have become the exception. Darius Moezzi, MD, senior partner and president of Flagstaff (Ariz.) Bone & Joint, argued in a column for Flagstaff Business News that the exception is worth preserving.
In the column, published Aug. 3, Dr. Moezzi laid out why he believes independent orthopedic practices still have a place in healthcare, using his own practice as a case study.
Here are six takeaways from the column:
- Founded more than 50 years ago, Flagstaff Bone & Joint has grown into an orthopedic campus with more than 25 providers, an outpatient surgery center, on-site imaging, durable medical equipment services and a planned MRI service line. It remains the only locally owned, independent orthopedic practice serving Northern Arizona, Dr. Moezzi wrote, a distinction he said has become increasingly rare.
- Nationally, about half of orthopedic surgeons remained in private practice as of 2024. Dr. Moezzi said rising operational costs, declining insurance reimbursements and administrative burdens push most new physicians toward employment with health systems or private equity-backed organizations.
- Those models can offer physicians financial stability and relief from the responsibilities of running a practice, Dr. Moezzi wrote. However, he argued they often come with a trade-off: less physician autonomy and a reduced focus on patients as clinical decisions become shaped by corporate policies or financial targets rather than individual patient needs.
- Physician ownership means the practice answers to patients rather than shareholders or a corporate office, Dr. Moezzi wrote. He pointed to Flagstaff Bone & Joint’s transparent pricing for uninsured patients and those with high-deductible health plans as an example and said the practice intends to continue investing in access and technology “because we believe independence allows us to remain focused on what matters most, our patients.”
- Dr. Moezzi argued consolidation does more than risk deprioritizing patient care; it also increases overall healthcare costs. He cited a study published in JAMA that found prices paid to health system-employed physicians and hospitals were 12% to 26% higher for physician services and about 31% higher for hospital services than prices paid to independent physicians and hospitals. He added that those higher costs come without a consistent corresponding improvement in patient outcomes.
- The debate Dr. Moezzi addressed is playing out across orthopedics. Independent practice leaders who have spoken with Becker’s have offered a range of views. Andre Blom, CEO of Des Plaines, Ill.-based Illinois Bone & Joint Institute, has said consolidation is inevitable but independence remains achievable for groups willing to adapt. Meanwhile, leaders at Geneva, Ill.-based Fox Valley Orthopedics have argued that true independence is no longer viable for most practices because of margin pressure and rising capital requirements.
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