After a decade of private equity deals and practice consolidation, orthopedic surgeons at an Illinois ASC say younger surgeons are becoming more skeptical of giving up control of their practices.
“It used to be coming out of residency that 70% would go into private practice, 20% would go into an employment model, 10% would go into academics,” Xavier Simcock, MD, an orthopedic surgeon at Oswego, Ill.-based Kendall Pointe Surgery Center, told Becker’s. “Those numbers have flipped now.”
Employment has climbed across medicine. By January 2026, 82% of U.S. physicians were employed by hospitals or corporate entities, up from 52% at the start of 2018, according to a Physicians Advocacy Institute-Avalere Health report. The report groups private equity with other corporate owners and does not break out specialties.
Orthopedics has held up better than many specialties. Fifty-four percent of orthopedic surgeons were in private practice, compared with 42.2% of physicians overall, according to the AMA’s Physician Practice Benchmark Survey published in 2025.
Dr. Simcock said the past five to 10 years of PE deals and consolidation made employment models “very, very common.” He said trainees have now watched that play out.
“As trainees, they’re aware of what PE brings to the table and how that influences their careers, and they’re more leery of that,” he said. “They’re more leery of having less control in their day-to-day.”
Private equity firms acquired 89 U.S. orthopedic practices from 2016 to 2023, and by 2023, 4.8% of the nation’s orthopedic surgeons worked in a private equity-affiliated group, according to an Oct. 15 study published in JBJS Open Access.
He acknowledged that some surgeons prefer employment because they don’t have to manage the business side. But he said autonomy is drawing some back toward independence.
“At the end of the day, what actually makes us happy is a lot of times the ability to tailor those things in our day-to-day to make us more efficient, so that we can get home to our kids and do the things we want to do without having to fight it,” he said. “That’s why [there’s] a little bit of that pendulum switch back.”
Jorge Chahla, MD, an orthopedic surgeon and vice chair of the Kendall Pointe board, said much of physicians’ frustration comes from feeling unable to make decisions.
“When [physicians] can’t treat patients the way that they want to, and they’re not able to make decisions on their own team and in their environment, it makes it really challenging,” he told Becker’s.
He said his group can add staff when everyone is stretched thin and can change hours, locations and surgery centers, which affects both care and how happy surgeons are.
Dr. Simcock also questioned the growth model behind many PE deals, which he said depended on growth to succeed. “That growth for growth’s sake, we all know, leads to bad outcomes and lost revenue,” he said.
Scott Sporer, MD, an orthopedic surgeon and chair of the Kendall Pointe board, said ownership gives surgeons a vested interest in the whole patient experience. In a hospital, surgeons can control the surgery itself but little before or after it.
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