A seismic shift has occurred in physician autonomy. Historically, most US doctors were "owners" of their practices. By 2026, more than 75% of US physicians are estimated to be employees of a larger entity rather than partners in a private practice.

• Drivers of Employment: Rising overhead, complex electronic health record (EHR) requirements, and the desire for a better work-life balance have pushed younger doctors toward salaried positions.

• Impact on Autonomy: While employment offers financial stability, many physicians report "moral injury" or burnout due to lost clinical autonomy and high "relative value unit" (RVU) productivity quotas set by corporate owners.