In the face of a deteriorating healthcare system, many independent doctors are finding themselves with no choice but to retire prematurely. Dr. Lisa Bohman Egbert, an OB-GYN from Dayton, Ohio, recently closed her 27-year practice, leaving thousands of patients in search of new medical care. Her story is emblematic of the challenges faced by private practitioners across the country. Despite years of dedication and service, financial constraints and systemic issues have rendered small medical practices unsustainable. The combination of reduced reimbursements, rising operational costs, and policy failures has left independent doctors like Dr. Egbert with little recourse but to shut down their clinics.

Dr. Egbert's journey began with a passion for patient care, but over time, she found herself grappling with increasing financial pressures. In December 2024, after nearly three decades of serving her community, she was forced to close her doors due to economic hardship. What started as a dream turned into a struggle to keep her practice afloat. Initially, she earned a modest $150,000 in 1997 when she took over the private practice. However, by the time she retired, her income had dwindled so much that she stopped taking a salary altogether, relying on personal savings to sustain her operations.

To combat these financial challenges, Dr. Egbert implemented various cost-cutting measures. She relocated her office to reduce rent, eliminated staff positions, and even sacrificed her own earnings to ensure her remaining employees were paid. These efforts, however, only delayed the inevitable. The decline in Medicare payments, compounded by inflation and the impact of the COVID-19 pandemic, made it increasingly difficult for her to maintain a viable practice. As the speaker of the American Medical Association (AMA) House of Delegates, Dr. Egbert has witnessed firsthand the broader implications of these issues, which extend far beyond her personal experience.

The AMA has been advocating for reforms in Medicare payment structures, recognizing the dire situation faced by independent physicians. Between 2012 and 2022, the percentage of doctors working in private practice dropped from 60.1% to 46.7%. This trend is expected to continue, as Medicare payments have decreased by 33% since 2001 when adjusted for inflation. Meanwhile, the cost of running a medical practice has surged by 59%. For OB-GYNs like Dr. Egbert, who primarily serve younger patients, the impact of Medicare cuts may seem less direct, but the ripple effect on private insurance reimbursement rates cannot be ignored. With limited bargaining power, small practices are often left with no choice but to accept unfavorable terms or go out of network, making healthcare less accessible for patients.

The future of private practice hangs in the balance, and solutions are urgently needed. The Medicare Payment Advisory Commission (MedPAC) has recommended linking physician payments to the growth in practice costs, a move strongly supported by the AMA. Congress must act swiftly to reverse recent cuts and implement sustainable policies that reflect the true cost of providing care. Dr. Egbert's story highlights not only the personal toll on individual doctors but also the broader consequences for patients who rely on the personalized care provided by local physicians. While she wishes to continue practicing, the current system leaves little room for hope. Ultimately, the fate of independent practices—and the patients they serve—rests in the hands of policymakers who must recognize the urgency of this crisis.