Physician Practices, Outpatient and Ambulatory Care

Physicians control most decisions in healthcare (admissions, referrals, procedures, prescriptions), but receive only about a fifth of US health spending as payment for their own services ("physician and clinical services," ~$1 trillion a year; verify latest CMS figure). Over twenty years the independent physician practice, once the default, has become the exception: by January 2026 about 82% of US physicians worked for hospitals, health systems or other corporate owners such as insurers and private-equity-backed groups (PAI/Avalere, reported). At the same time care has moved out of hospitals into ambulatory surgery centers, urgent care, retail clinics and virtual visits. This section explains how physicians are paid, why practices sell, what buyers want from them, the economics of ambulatory surgery and urgent care, why primary care is both under-funded and strategically prized, and what the retail and big-tech primary-care wave (VillageMD, Walmart Health, One Medical, Oak Street) taught investors.