I worked the last 11 years in healthcare finance, and I retired 14 years ago. Pulmonary practices were not viable on their own because of low reimbursement. Many cardiologists were also not able to survive in private practice. Medicare had much to do with that. Billing and collections is a complicated process for providers, physicians and hospitals. The US is a capitalist country, and we don’t have socialized medicine yet. Healthcare spending was 18% of
GNP in 2023, and is expected to be 20% by 2031. I tried to get my arms around this issue when working in it, and found it too huge, the federal government is the only thing bigger! I do not believe, based on my own research , that private equity is solely responsible for large doctor bills. It takes the individual timely research to determine what healthcare insurance they can afford. According to The National Health Council, chronic illnesses like heart disease is responsible for 75% of healthcare spending. Interventional cardiologists earn the most, $694,000.00 a year. This is a daunting challenge to overcome!!

Groups of Doctors have been building practices for years and it is good and bad. I can still see a Doctor if mine is ill, retires, on vacation, etc. I can request a different Dr in the group, usually, if I don't mesh with a particular one. The Dr's cut down on overhead, are happier with colleagues to consult and spend time with rather than being isolated. Even the veterinarians are doing this. My vet joined a group that has lifts for bigger animals which has allowed him to continue as he was having back problems and considered retiring. The problem is when large corporations buy up nursing homes and practices. They dictate to the Dr's and nurses everything down to personal protective equipment use and availability, staffing and policy but many of these people are "desk jockeys" who have no clue and no interest in listening. For many years hospitals were built with the sickest being farthest from the nursing station hub, for instance. I don't see it getting any better.