The Chief Complaint, No. 1: Who Owns Your Doctor?

A family doctor who still owns her practice, on who owns yours. For anyone who has been a patient, sat beside one, or worked the shift.

The Complaint

The person who decides how long your doctor gets with you, or with your mother, may never have met a patient. A bill in Congress, built on a rule Oregon has had since 1947, would take that power away.

It is called the Stop Corporate Takeovers of Physicians Act, introduced September 16 in both chambers (H.R. 10444 and S. 5419) by Senators Elizabeth Warren, Ron Wyden and Jeff Merkley and Representatives Val Hoyle, Alexandria Ocasio-Cortez and Suhas Subramanyam. It would do three things:

• Bar for-profit corporations, private equity firms and insurers from owning or controlling medical practices.
• Close the loophole they use to do it anyway.
• Ban the non-competes that keep physicians from walking out the door.

None of this is a new idea. Oregon settled it in 1947, when its Supreme Court ruled in a case called Sisemore that, in effect, a corporation cannot hold a license, so a corporation cannot practice.

Then came the exceptions. A 1975 attorney general opinion, as summarized for the Oregon Legislature, carved out hospitals. Across the country, the managed-care era loosened the rules, and lawyers built the workaround still in use today: a corporation-owned management company runs the practice, a "friendly physician" signs the paper, and the doctor in the room owns nothing that matters.

On June 9, 2025, Oregon shut that door. Senate Bill 951, signed by Governor Tina Kotek, says a management company may not control hiring, pay, schedules, billing, clinical standards or who owns the shares. It reaches practices formed after it passed starting January 1, 2026, and existing practices by January 1, 2029. Fifteen months later, Congress copied it.

Sooner or later everyone sits in an exam room, as the patient or beside someone they love. The owner was in that room too. They set how long the visit lasted, where the referral went, how long you waited on hold. If you work in healthcare, they set your schedule, your staffing and your caseload. If you are a physician, they can decide whether you may keep caring for your patients after you leave. That is the non-compete. This bill would end it.

The Chart

This week: INDEPENDENT PRACTICE, a single origin Guatemala from Huehuetenango, medium roast. Lemon, nougat and brown sugar, all from the bean. Named for what this bill is trying to protect. The story behind the name posts Monday.

Next week: THE COOPERATIVE, for issue two, about everyone else who runs the place.

The Order

Thanking a care team for PA Week (October 6) or Pharmacy Week? The gift guide is sorted by who you are buying for. Free shipping over $50.

Rounds

Do you know who owns the practice where you, or someone you love, gets care? Not the name on the door. The name on the deed.

If you work in healthcare: who owns the place you work, and when did you find out?

Reply. First names only, with permission, in a future issue.

Sign-out

Happy International Coffee Day. Every bean we sell was grown in another country, by people we will never meet. Today we raise a cup to them.

I am a family physician in a county with few independent practices left, and I own one of them. Direct Primary Care is how I chose to do that. It is what I personally advocate for, and it is the only reason a coffee company with a cross on the cup exists.

Despite it all, we're still here.
Maryal

Sources: H.R. 10444, Stop Corporate Takeovers of Physicians Act of 2026, 119th Congress, introduced September 16, 2026 · S. 5419, Stop Corporate Takeovers of Physicians Act of 2026, 119th Congress · Sponsors' press release, September 16, 2026 · State ex rel. Sisemore v. Standard Optical Co., 182 Or. 452, 188 P.2d 309 (1947) · Oregon Senate Bill 951, 2025 Regular Session, enrolled text · Oregon Legislature, "The Corporate Practice of Medicine Doctrine in Oregon" (2023 interim committee document).