The Future of Independent Medicine: Technology Without Trade-Offs

Independent medical practices face a difficult balancing act: They’re being asked to deliver more sophisticated, connected and efficient care while managing rising operating costs, growing administrative demands and increasingly complex technology requirements. Large health systems often have advantages in capital, purchasing power, analytics and centralized operations. Smaller practices, however, can offer something equally valuable: direct physician-patient relationships, flexibility and the ability to adapt care to individual needs.

The challenge is determining which advantages to borrow from larger organizations without importing the bureaucracy that can undermine independent practice.

For members of the Senior Executive Healthcare Think Tank, a curated group of experts specializing in patient experience, workforce strategy, policy, quality, equity and healthcare technology, the answer is not to replicate the health system model wholesale. Instead, independent practices should identify the capabilities that benefit from scale and preserve the clinical relationships that make their care distinctive.

Here, they explain how shared infrastructure, intelligent automation and operational discipline can help independent practices become more resilient while keeping clinical decisions and patient experience firmly in local hands.

“Centralize what creates efficiency; preserve autonomy where it creates better care.”

– Asaad Hakeem of SARC MedIQ Inc.

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Centralize Infrastructure, Not Clinical Judgment

Asaad Hakeem of SARC MedIQ Inc. believes independent practices should selectively adopt the infrastructure advantages of larger organizations.

“Independent practices should adopt the scale advantages: shared infrastructure, data analytics, cybersecurity, purchasing power and standardized administrative workflows,” Hakeem says.

The key distinction is between standardizing how a practice operates and standardizing how a physician thinks. Shared billing systems, purchasing agreements, cybersecurity controls and reporting processes can reduce duplication without requiring clinicians to follow identical approaches to every patient.

“They should resist standardizing clinical judgment and patient relationships,” Hakeem says. “Centralize what creates efficiency; preserve autonomy where it creates better care.”

For practice leaders, this means assessing every potential standardization initiative against two questions: Does it remove unnecessary work, and does it preserve the physician’s ability to respond to the individual patient?

Share Business Operations Without Selling Independence

David Zechman, President of The Zechman Group and retired hospital president and CEO, emphasizes a point that independent physicians should consider before pursuing a partnership: Sharing infrastructure does not have to mean surrendering ownership.

“Independent practices can explore models that allow for back-office business functions to be shared with other large practices, practice management companies or with large healthcare systems,” Zechman says.

Such arrangements can help practices access expertise and infrastructure that would be expensive to maintain independently. Revenue cycle management, payroll, human resources, contracting, compliance and information technology are potential candidates for shared services, depending on a practice’s needs and the terms of the arrangement.

“This would not include selling the practice to a healthcare system or a third-party investor, but finding ways to share the business infrastructure that would allow the practice to maintain its clinical practice independence,” he says.

Before signing a shared-services agreement, practice leaders should establish clear decision rights, service-level expectations, pricing transparency and exit provisions. They should also understand who controls patient data, how records can be transferred and whether the arrangement limits the practice’s ability to work with other partners.

Adopt Operational Discipline Without Importing Bureaucracy

Sriharsha Chavali, Engineering Lead for a leading national dental services organization, offers a central recommendation for smaller practices: Build reliable operations that give clinicians more time to care for patients.

“Independent practices should adopt the operational discipline of larger organizations without importing the bureaucracy that can distance physicians from patients,” Chavali says.

He sees shared infrastructure as a way to improve performance across multiple functions, including cybersecurity, compliance, revenue cycle, analytics, purchasing, technology and quality reporting.

“The goal is not to become a small health system, but to build shared infrastructure that lets physicians spend more time practicing medicine and less time managing avoidable complexity,” he says.

Chavali also stresses that the benefits of scale should not dictate the details of every patient encounter.

“The physician-patient relationship is different,” he says. “Clinical judgment, scheduling and responsiveness to the community should remain local.”

Practices can translate this principle into action by establishing a small set of organization-wide standards for safety, documentation, data quality and operational performance while allowing individual clinicians to adapt visit length, communication and follow-up to patient needs.

“Standardize what happens behind the physician, not what happens between the physician and patient,” he says.

“Keep clinical pathways, specialist referrals and treatment plans in the hands of the doctor, preserving the personalized care that large health systems often flatten.”

– Mahendran Chinnaiah, Digital Healthcare Architect at a major U.S. healthcare and pharmacy services firm

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Protect Clinical Autonomy at the Point of Care

Mahendran Chinnaiah, a Digital Healthcare Architect at a major U.S. healthcare and pharmacy services firm, reinforces the importance of separating operational consistency from clinical uniformity.

“Independent practices shouldn’t try to reinvent operations that large systems do best,” Chinnaiah says. “They should adopt shared-service infrastructure—like automated claims adjudication, enterprise cybersecurity, cloud-based scheduling and aggregated purchasing power.”

These capabilities can help smaller practices reduce the cost of maintaining secure, reliable operations. Shared infrastructure can also improve access to technology and expertise that might otherwise be beyond a practice’s budget.

However, Chinnaiah warns that operational efficiency becomes counterproductive when organizations impose rigid expectations on the clinical encounter.

“Reject rigid productivity quotas,” he says. “Resist system-mandated 10-minute visit templates and algorithmic throughput targets that erode clinician-patient trust.”

Chinnaiah also emphasizes the importance of preserving physicians’ authority over diagnosis and treatment.

“Keep clinical pathways, specialist referrals and treatment plans in the hands of the doctor, preserving the personalized care that large health systems often flatten,” he says.

The objective is to use standardization to make good care easier to deliver—not to make every clinical decision identical.

Make Personalization the Standard, Not the Exception

Dorothy Riviere, Founder and CEO of Work Resilience, notes that patients who share a diagnosis may have very different needs, behaviors and circumstances.

“I have treated the same job, the same injury, in bodies 20 years apart,” Riviere says. “They were never the same patient.”

Large organizations often pursue efficiency by applying common pathways across high volumes of patients. Shared protocols can reduce unwarranted variation and support safety, but they cannot account for every relevant difference in an individual’s life.

“Independent practices should adopt what makes that work: the data infrastructure, the interoperability, the technology that gives a physician a fuller picture before the patient sits down,” she says.

That fuller picture may include prior treatment, functional limitations, patient preferences, social circumstances and how a condition affects daily life. Better information can help clinicians spend less time reconstructing a patient’s history and more time understanding the person behind it.

Riviere illustrates her point through two patients with low back pain. One is 24 and experiences pain related to movement patterns. Another is 58 and believes rest is the only solution, potentially prolonging the problem.

“Same diagnosis, different reasons,” she says. “A standardized pathway treats them the same. A physician doesn’t.”

Practices can reinforce this approach by measuring patient-reported outcomes, reviewing exceptions to standard pathways and asking whether care plans reflect individual goals. Technology should help clinicians identify meaningful differences, not erase them in the name of efficiency.

Build Technology Partnerships That Preserve Choice

Tirumala Ashish Kumar Manne, Principal Cloud Architect at Optum, offers a useful framework for practices evaluating external platforms: Share the technical foundation while retaining control over how patients experience care.

“Independent practices should borrow the shared utility layer and keep the experience layer for themselves,” Manne says.

He identifies identity and access management, cybersecurity, claims and revenue cycle workflows, FHIR-based interoperability and shared data platforms for analytics and quality reporting as capabilities that practices should consider adopting through shared infrastructure.

“These are commodity capabilities, and rebuilding them alone taxes physician time,” he says.

Manne cautions that technical integration should not dictate the patient experience.

“Resist standardization where judgment and relationship live: clinical decision-making, visit structure, scheduling rhythm, patient communication and care team design,” he says.

He also advises practices to negotiate for data portability and open APIs before committing to a platform. Contracts should clarify how information can be exported, what integration capabilities are available and what happens if the practice changes vendors.

“Scale should remove friction, not physician voice,” Manne says.

“Independent practices win when they optimize the opportunities for clinicians to practice at the top of their licenses.”

– Mark Francis, Founder and CEO, CaregiverZone Inc.

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Automate the Undifferentiated Work

Mark Francis, Founder and CEO of CaregiverZone Inc., says organizations should not spend scarce clinical resources managing work that technology can handle reliably.

“Independent practices win when they optimize the opportunities for clinicians to practice at the top of their licenses,” Francis says.

During his time at Amazon Web Services, he says, the focus was on “doing the undifferentiated heavy lifting” so companies could concentrate on their core business. He notes that the same is the case for independent practices.

“As many non-clinical, non-patient-facing applications and workflows as possible should be automated through the use of agentic AI coupled with modernized data and compute architectures,” Francis says.

Francis also emphasizes that technology should be designed around the people who use it.

“Systems should be designed and implemented—particularly the interfaces—so that the complexities of interoperability, regulatory compliance, coding and more are invisible to the clinical staff and patients,” he says.

The most effective automation is not the most visible. It is the kind that makes routine work easier while preserving human accountability for decisions that affect patients.

Key Tips for Independent Practice Leaders

• Centralize capabilities that benefit from scale. Explore shared services for cybersecurity, analytics, purchasing, billing and administrative workflows rather than duplicating costly infrastructure.
• Share infrastructure without surrendering ownership. Evaluate partnerships that provide back-office expertise while protecting clinical decision rights, data access and the ability to exit the arrangement.
• Standardize essential processes, not every interaction. Establish consistent safeguards for security, compliance and quality while letting clinicians adapt care delivery to individual patients.
• Protect clinical judgment from productivity pressures. Review performance measures to ensure that efficiency targets do not undermine appropriate visit lengths, diagnostic freedom or patient trust.
• Invest in technology that supports personalized care. Improve interoperability and access to patient information so physicians can make more informed decisions without treating every patient identically.
• Negotiate for interoperability and data portability. Require clear contractual provisions for open APIs, information exchange and transitions between technology providers.
• Automate routine work with human oversight. Prioritize low-risk administrative tasks, measure actual time savings and establish safeguards for AI-assisted workflows that affect clinical operations.

Scale Smartly, Stay Independent

The future of independent medicine will depend not on whether practices can match the size of large health systems, but on whether they can access the right capabilities without losing control of how they care for patients. That requires a shift in how leaders think about growth: Technology and operational infrastructure should strengthen a practice’s independence, not gradually replace it with someone else’s priorities.

As AI, data analytics and connected care continue to reshape healthcare, independent practices have an opportunity to define a model that combines the best of both worlds and to make innovation work for physicians and patients—not the other way around. In an industry increasingly shaped by scale, the ability to remain personal, responsive and independent may be the most important advantage of all.