From Patients to Consumers — The Corporatization of Ambulatory Care

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Source: NEJM

Original: https://www.nejm.org/doi/full/10.1056/NEJMp2415483?af=R&rss=currentIssue...

Published: 2025-12-26T03:00:10Z

This article describes the transition from patients to consumers in ambulatory care through the corporatization of health care. Corporatization emphasizes profit maximization for shareholders instead of patient welfare, which includes horizontal consolidation, such as hospitals merging in the same market, and vertical consolidation, such as insurers buying physician practices and pharmacies[1]. According to statistics, 70% of physicians work for corporate entities, which reduces their autonomy in decisions[2]. This change erodes the doctor-patient relationship by introducing pressure to increase profits for management companies or investors into decisions about the patient's best interest[1]. Hospitalizations lead to new bills from the hospital and different physicians in new economic arrangements, which increases prices[2]. Consolidation reduces access to care by eliminating independent medical practices as a source of choice for patients, with decreases ranging from 4% to 42%[3]. Nearly 60% of physicians report loss of clinical autonomy and greater emphasis on financial incentive as a negative impact of ownership changes[3].