Here is the link to current physicians accepting patients at U of R
PCP_1059_ACCEPTING_PATIENTS_NOV_REV.pdf
https://www.medpagetoday.com/opinion/second-opinions/118254?trw=no
For more than a century, American medicine has been anchored by the independent physician -- a professional who owned their practice, managed patient care, and participated in civic medical life through county and state societies. That archetype is fading fast. A growing majority of doctors now practice as employees, and this shift poses an existential challenge for medical societies built around a model of independence that no longer reflects reality.
The End of the Independent Majority
According to the American Medical Association (AMA), 2020 marked the first time that fewer than half (49.1%) of physicians worked in doctor-owned practices since their tracking began. By 2022, that number had fallen further to 46.7%, down from 60% a decade earlier. Meanwhile, the share of physicians employed by hospitals and health systems has expanded sharply -- from about 29% of physicians in 2012 to more than 40% in 2022. Private equity ownership, virtually absent in previous decades, now accounts for roughly 5% of physician employment.
The forces driving this shift are not ideological -- they're economic and administrative. Four in five physicians who moved to employed settings cited better leverage in payer negotiations, while 70% pointed to relief from the regulatory and operational burdens of solo practice. For many, aligning with larger entities was the only way to survive in today's complex reimbursement and compliance landscape.
The Membership Decline Crisis
This employment transformation has disrupted the very institutions meant to represent physicians. Nationally, AMA membership has plunged from about 75% of U.S. physicians in the 1950s to just 15% today. State and county medical societies mirror this pattern, facing shrinking memberships, aging leadership, and limited engagement among younger doctors.
Specialty societies have filled much of that vacuum. Groups like the American College of Physicians, the American College of Surgeons, and the American Academy of Family Physicians have seen significant growth over the past few decades. Their rise underscores a broader shift in professional identity -- toward communities defined by clinical specialty rather than geography or general advocacy.
Local societies, meanwhile, often lack the infrastructure and staff to deliver value commensurate with membership dues. Though they continue to offer CME events, scholarships, and social gatherings, these efforts rarely outweigh the time and cost constraints on modern employed physicians.
The generational divide adds another layer to this challenge. Many early-career physicians do not view large medical society participation as a professional obligation. The younger cohort sees medicine less as a life-defining calling and more as one component of a balanced life. Sociologist Robert Putnam's "bowling alone" thesis applies neatly here: today's physicians are more networked digitally but less connected institutionally. That pattern makes traditional membership recruitment difficult.
A Profession in Search of Voice
The transition to greater physician employment by large health raises important questions about physician satisfaction and professional autonomy. On the one hand, employment by a large hospital or health system can, at times, help improve practice environments and address organizational and systems issues that previously fell on independent practitioners.
Yet, there's a paradox: even as some workplace stressors ease, many doctors feel a loss of autonomy.
Physician trust in the organizations that employ them has eroded. Fewer than half now believe their leaders are honest or transparent. Only 47% say they trust leadership to make patient-centered decisions -- a decline from 53% the year prior. This disconnect signals a deeper identity tension: the corporate healthcare environment often values efficiency, while physicians are trained to value individual patient outcomes.
The trust gap appears wider in nonprofit hospital systems than in investor-owned or private companies, a counterintuitive finding that may reflect communication styles more than structural differences. Whatever the cause, it reinforces a growing unease among employed clinicians.
Unionization and Collective Advocacy
This erosion of trust has quietly fueled another development -- rising physician interest in unionization. More than two-thirds of doctors have a favorable view of physician unions, though only about 1% belong to one.
That sentiment reflects a hunger for collective representation beyond the confines of their employers. It also hints at a potential opportunity for medical societies: to reclaim relevance by becoming independent advocates for physicians' professional interests in a corporate-dominated environment.
Reimagining the Role of Medical Societies
Medical societies no longer have the luxury of nostalgia. Their path forward requires redefinition, not restoration.
First, societies must pivot from being membership clubs for practice owners to advocacy anchors for all physicians -- employed or independent. Employed doctors face unique challenges around contract negotiation, compensation structures, noncompete clauses, and performance metrics. Medical societies are well positioned to provide impartial guidance, legal resources, and leadership training that employers cannot.
Second, societies should expand their advocacy portfolio beyond legislative engagement. The most urgent concerns for physicians -- prior authorization reform, electronic health record usability, and administrative overload -- transcend employment status. Medical societies that push for practical system-level improvements can demonstrate immediate relevance.
Third, societies should adopt new membership models that reflect the time and financial constraints of today's workforce. Tiered memberships, institutional partnerships with health systems, or free basic memberships supplemented by value-added services could attract early-career physicians who might otherwise remain disengaged.
From Organizations to Movements
The concept of "system citizenship" emerging from medical education circles offers a useful philosophical frame. It encourages physicians to see themselves not just as clinicians, but as stewards of the healthcare system itself -- balancing organizational, patient, and community health. Medical societies can become conduits for this kind of engagement, helping physicians bridge the divide between frontline care and system-level leadership.
If medical societies cling to models built for an independent-practice era, they risk fading into irrelevance. But if they harness their history of advocacy to address the lived experiences of employed physicians, they can reclaim their place as essential professional anchors.
Ultimately, the employment shift is not the end of physician community -- it's a call to redesign it. Medicine's next chapter will not be written by individuals working in isolation, but by institutions that adapt to represent physicians where they are -- within the systems that now define their professional lives. For medical societies, survival will depend on whether they can translate that reality into renewed meaning.
Hemant Kalia, MD, MPH, is councilor, 7th District, of the Medical Society of the State of New York. Kalia is a dedicated physician, specializing in interventional pain medicine, and a public health advocate. Mark Adams, MD, MBA, is president-elect of the Medical Society of the State of New York. He is a board-certified radiologist, and a professor of Clinical Imaging Sciences at University of Rochester Medical Center. David Jakubowicz, MD, is president of the Medical Society of the State of New York. He is also director of Otolaryngology and Allergy at Essen Medical, and a clinical assistant professor of Otorhinolaryngology at Albert Einstein College of Medicine/Montefiore.
Today, the Monroe County Medical Society (MCMS) and District rises to make a bold and united statement: We are urging a veto of the Wrongful Death bill. Every outreach, whether it’s a phone call, voicemail, or conversation, amplifies our message and highlights the urgency of this moment.
Your voice matters. Let’s approach each interaction with confidence, clarity, and purpose. Our impact today is built on our shared commitment and collective action.
Thank you for standing together and speaking out!
Wrongful Death Bill Phone Call Campaign for MCMS Members:
Tuesday, October 21, 2025 & Tuesday, November 11, 2025 (or call anytime)
Our joint efforts have vetoed this bill in the past. Please join our phone call campaign on October 21, 2025 to help us protect the medical profession in New York State. All physicians and citizens must unite under MSSNY to fight the Wrongful Death Bill, as it will be detrimental to physicians and patients in both private practices and large hospital settings. Do your part by urging Governor Hochul to veto this bill and stay tuned for more updates from the Monroe County Medical Society.
TAKE ACTION TODAY by:
Click here to read the Letter Sent to the Governor's office from
MSSNY & Medical Societies
Due to a changeover of our phone system, our phone lines are temporarily unavailable. Please email us at MCMS@MCMS.org with any questions. We expect the phones to be up soon. Thank you.
Dear Monroe County Medical Society Board Members and Executive Director, Lucia Castillejo,
We are delighted to invite you to join us for the Medical Society of the County of Erie's Annual Gala and Awards on November 6th at the historic Twentieth Century Club, 595 Delaware Avenue, Buffalo.
This year's program features exceptional speakers and guests, including:
We have extended a personal invitation to Dr. Mark Adams, President-Elect of MSSNY, to join us as our guest for the evening. Dr. Thomas Lee will also be attending.
As neighboring medical societies, we share common challenges and aspirations. This evening provides an outstanding opportunity for regional collaboration and demonstrates the strength of physician medicine in Western New York. Your presence would send a powerful message about physician unity and collective advocacy across our region.
The evening will also mark an important transition as we pass the gavel to our incoming President, Dr. Michael Terranova, welcome our new board members and honor award recipients. Guests will enjoy a silent auction, information tables showcasing programs that serve our medical community, and meaningful conversations that strengthen our collaborative efforts.
We deeply appreciate our collaboration with Monroe County Medical Society and valued working alongside you at the recent House of Delegates. As you prepare to host this year's House of Delegates—no small task—please know we are here to support you in any way we can.
We would be honored if you came in force, secured a table and joined us for this special evening of celebrating physician medicine together.
Registration: https://www.wnydocs.org/event-6315648 Questions: Contact Jenna Mattson at jmattson@wnydocs.org
We look forward to welcoming you on November 6th.
With warm regards,
The Medical Society of the County of Erie Officers
Iris Danziger, MD, MSCE, President Michael Terranova, MD, FAAP, MSCE, President-Elect Michael Merrill, MD, MS, MS, MBA, Vice President Stacey Watt, MD, MBA, MHPE, FASA, Immediate Past President Natalka Stachiw, MD, Treasurer Nora Meaney-Elman, MD, Secretary
cc: Kathleen Van De Loo, MSCE Executive Director
Here is the October List of Primary Care Physicians accepting new patients:
PCP_1059_ACCEPTING_PATIENTS Oct_2025.pdf
From:
David Jakubowicz, MD, FACS MSSNY President
Colleagues:
The events of the past month threaten to undo a century of progress in public health.
On August 8, a gunman fired more than 500 rounds into the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta. His stated motive was to “make the public aware of his distrust of vaccines.” Officer David Rose, a local police officer who responded heroically, was killed. The gunman took his own life. Thankfully, no one else was injured.
Less than three weeks later, on August 27, the White House dismissed CDC Director Susan Monarez. Five of the CDC’s top leaders immediately resigned in solidarity. Within days, states began charting their own divergent paths. Washington, Oregon, and California announced the creation of a West Coast Health Alliance to provide evidence-based recommendations on immunizations and vaccine safety. Meanwhile, Florida moved in the opposite direction, preparing to allow residents to opt out of all vaccine mandates.
Taken together, these events reveal a disturbing trajectory: violence against public health institutions, political pressure undermining scientific expertise, and a growing patchwork of state-based vaccine rules.
A Dangerous Polarization of Medicine and Public Mistrust Medicine is at risk of becoming red-state and blue-state practice, while it should be based on science and objective evidence. Physicians may find themselves not only explaining the science but also battling political perceptions that frame their advice as partisan. In such an environment, the wrong word can cause a patient to dismiss sound medical guidance as “politically biased.” Worse, physicians may face ostracism, threats, or even violence.
Medicine should rise above politics. When a child is sick, or when a vaccine prevents deadly disease and protects newborns too young to be immunized, public health should unite us. Instead, political polarization and social media platforms that amplify distrust have eroded confidence in physicians and hospitals. According to a recent JAMA Network Open survey, public trust in these institutions has fallen below 50 percent.
Restoring Trust While the unprecedented measures taken during COVID-19 pandemic meant to stop the rapid spread of the disease meant well, some of the measures taken and affirmative and absolute claims made by political and public health officials turn out not to be based on solid and validated scientific evidence. The unintended consequences of these actions and claims unfortunately caused mistrust of public health and medical professionals when it comes to immunization. Rebuilding that trust will not be quick or easy. It will require diligence, empathy, humility, political skill—and unfortunately, money. In the exam room, physicians must meet patients where they are: listening first, giving them space to process, and respecting their need to “do their own research,” then offering their professional opinion. We need to go back to the basics of physician-patient relationship and communication without injecting our personal politics.
At the state level, public health leaders must continue to advocate for evidence-based policy, even while addressing public skepticism. Federally, we must be careful not to present science as immutable dogma. Instead, we should state clearly: these recommendations are based on the best available science today. It is important to transparently lay out the risks, benefits, and alternatives, if any, of any treatment we offer our patients. However difficult, restoring trust is essential for the health of our patients.
A Call for Leadership The actions of the past month are unacceptable. Leadership matters, and accountability matters. HHS needs to objectively analyze data and publish reasonable guidelines in a way that restores credibility and stability. Fragmentation of our public health policies will only set us back and should be avoided. Public health officials must be committed to science, public health, and rebuilding trust across the political spectrum, and be held accountable.
In the meantime, Senator Bill Cassidy, who chairs the Senate Health, Education, Labor, and Pensions Committee, should exercise rigorous oversight of federal health agencies. If the federal government cannot maintain credibility, states will continue to fracture along partisan lines—leaving Americans with unequal and uncertain access to public health protections.
Standing Firm Physicians across the country are practicing medicine under extraordinary pressure. They are heroic for continuing to serve patients in this volatile environment. But they cannot do it alone. Professional organizations, policymakers, and communities must stand with them.
We cannot remain silent while public health is politicized and trust in medicine erodes. The integrity of our health system—and the safety of our patients—depend on it.
All the best,
By Hemant Kalia, MD, MPH, FIPP
This article was published in the RBJ https://rbj.net/2025/08/01/a-gilded-cage-for-primary-care-the-dangerous-promise-of-new-health-care-law/
For years, physicians pioneering the Direct Primary Care (DPC) model have fought for a simple change: to allow patients to pay for their affordable, membership-based primary care using their tax-advantaged Health Savings Accounts (HSAs). The recently passed One Big Beautiful Bill Act (OBBBA) finally delivers that victory. Effective Jan. 1, 2026, DPC arrangements will no longer be considered disqualifying health coverage for HSA purposes.
This is, on its face, a landmark achievement. It treats DPC membership fees — capped at a reasonable $150 a month for an individual — as a qualified medical expense, not an insurance plan.1,2 This single change unlocks a vast market of millions of Americans with high-deductible health plans, giving them a powerful new way to access comprehensive, relationship-based primary care. For physicians, it offers a path away from the burnout of fee-for-service bureaucracy and toward a more sustainable and patient-focused practice model.
But this victory is dangerously deceptive. It is a beautiful, gilded cage built in the middle of a collapsing ecosystem. While the OBBBA hands DPC a powerful new tool with one hand, it dismantles the rest of the health care safety net with the other.
The same law is projected to strip health insurance from an estimated 12 million Americans through massive cuts to Medicaid and the Affordable Care Act. This will not happen in a vacuum. The newly uninsured will still get sick, but they will delay care, arriving in emergency rooms with more advanced and costly conditions. This will trigger a tidal wave of uncompensated care — projected to cost physicians $24 billion and hospitals $63 billion over the next decade.2,3
A pyrrhic victory for physicians?
This is where the gilded cage slams shut. DPC practices do not exist on an island. They depend on a stable network of specialists and hospitals for referrals and escalations. What happens when a DPC patient needs a colonoscopy, a cardiac stress test, or an urgent surgical consult? They are sent to the very specialists and hospitals that will be buckling under the financial strain of uncompensated care.
When local hospitals are forced to close service lines, lay off staff, or shut their doors entirely — as many health care organizations predict will happen — a DPC membership becomes a ticket to a broken system. The promise of better primary care is undermined if there is no reliable specialty or hospital care to back it up.
The OBBBA’s gift to DPC is a classic Faustian bargain. It offers a clear and immediate business opportunity in exchange for systemic instability that threatens the viability of the entire health care community. True innovation cannot flourish in a system facing financial collapse. Unless we address the profound, indirect harms of this legislation, the long-awaited victory for Direct Primary Care may prove to be a hollow one indeed.
Hemant Kalia MD MPH FIPP is Consultant, Interventional Pain & Cancer Rehabilitation Medicine; CEO & Chief Medical Officer, Savya Neuroscience Institute; and President & CEO, C.R.I.S.P Center for Research & Innovation in Spine & Pain.
1https://www.ralaw.com/media/insights/alert/blog_post_or_one_big_beautiful_bill_a_boon_for_concierge_medicine
2https://www.congress.gov/bill/119th-congress/house-bill/1/text
