EHRs: The Booster for Private Practices

Jeremy Shiner

Feb 2, 2022

In recent years it’s become more common for physicians to leave their practices for employment by large corporations or hospitals. In fact, between 2019 and 2021 nearly 21,000 private practices were acquired by hospitals or corporate entities, and 48,000 physicians left private practices to work for these institutions – representing a 25% increase in corporate-owned practices and a 12% increase in the total number of physicians employed by hospitals or corporations.[1] To paint a bigger picture, by the end of 2021 almost half of all U.S. medical practices were owned by corporations or hospitals.

While business ownership may seem risky and opting for employment under a larger corporation may help avoid various financial and liability risks, stress and uncertainty, what exactly do physicians lose when they go the corporate route?

Higher Earning Potential

For new physicians just out of their residencies, joining hospitals or large corporations may seem the obvious decision while they pay off their medical school debt, but this comes with a salary cap. In a private practice setting, the physician receives all or a portion of the profits. They have direct control over how services are priced and delivered and how the earnings are spent. Outside of annual earnings, as owners physicians have full control over the value of their practice, and when it comes time to retire thus receive an appropriate buyout.


Corporate employment may come with more readily available resources and equipment that are in a sense ‘free,’ in that physicians don’t have to source nor purchase themselves, but in turn they give up the power to make decisions on what equipment and resources are used.

Large healthcare corporations and hospitals are often led by business executives who have little to no medical training but have direct influence and power over the decisions physicians can make, ranging from tests and surgeries performed to medicines and tools to use.

In a private practice setting, physicians have full autonomy to make decisions on how their office runs based on their personal preferences – ranging from what practice management software and credit card processing to use to payment plans, pricing, hours worked and other managerial items. Private medicine empowers physicians to be the sole decision makers.

Doctor-Patient Relationships

In a corporate medical setting, doctors are often required to see a certain number of patients per month, often cutting visits short. Patients are not guaranteed to see the same doctor every visit, and with every switch the doctor must spend time to learn the patient’s history. Not every physician is the same and may not agree with the treatment plan established by the doctor from the last visit – resulting in confusion, wasted time and decreased care.

Private practices tend to have less focus on increasing the number of new patients and rather on providing existing patients with the best, most comprehensive treatment. The sacred doctor-patient relationship consists of just the necessary parties – the doctor and the patient. Doctors have the time to get personal with their patients and build relationships, increasing the quality of care, patient trust and loyalty – which will provide a natural, more sustained and long-term increase in patient count.

Innovation vs. Complacence

Despite extremely large budgets, corporate healthcare systems tend to provide very standardized care. Most healthcare innovation comes from physician-led practices or startups, not the hospital. Privately-owned practices take holistic approaches to patient health and wellness, putting the patient at the center to address a comprehensive range of physical, emotional, mental, social and environmental factors that could be affecting their health.

With less pressure to see more patients per day, private physicians have the time and interest to look at the big picture and find innovative solutions for conditions. Corporate systems generally only look at the list of symptoms on intake forms rather than assessing outside yet crucial factors.

How to Thrive in Private Medicine

As mentioned, private practice has a lot of upfront costs. Research estimates that startup costs can range from $70,000 to over $100,000 with monthly costs of $6,000.[2] A huge chunk of this comes from vendor costs such as electronic health record (EHR) software, credit card processing, payroll, internet, and phone systems.

EHRs are the foundation of private practices. From them, office staff can schedule appointments, communicate with patients, store medical records, and physicians can access all critical data from one platform versus endless paper records. While crucial, the average initial purchase and implementation of an EHR ranges from $26,000 to $33,000 with yearly costs ranging from $4,000 to $8,000.[3] For a physician just starting out this can be crippling, but it may be required based on location.

There are so many small fees providers have to pay to practice – transcription costs, administrative costs and time, billing costs, communication costs and more. EHRs are one of the top solutions to helping private practices thrive. Although expensive, over time, EHRs actually wind up saving a practice tremendous money realized through increased efficiency, less errors, higher quality of care, customization, financial reports and more.

There are many EHRs readily available and most of them are sold at 2,000% above cost. Many physicians, especially those starting out, are unable to take on the implementation and monthly costs for EHRs, and somewhat forcibly opt to go the corporate medicine route. But there is one truly free EHR and billing software. Myriad Health from Myriad Systems builds upon and incorporates its background in revenue cycle management into its mission to provide great EHR and billing software at roughly a 1,998% lower profit margin and with all comprehensive features. Myriad Systems is determined to help private practices thrive in the age of corporate medicine by streamlining systems and lowering costs.

About The Author

Jeremy Shiner has been around the healthcare payment industry his entire life, witnessing his father build the largest healthcare payment processor in the country. After graduating from the Catholic University of America, Jeremy joined his father and ascended the ranks rapidly, winning the Highest Rookie Sales award in his first year. In less than three years, Jeremy was the top salesperson in the nation and received two consecutive Representative of the Year awards. In his final year, Jeremy partnered with more new clients in one single year than any other representative since the company’s inception.

After four excellent years, Jeremy launched his own organization, Myriad Systems. Myriad Systems is committed to empowering private practices with Myriad Health, the first-ever truly free EHR and billing software, and MediPay Compliance Consultants, the only payment processing company that is exclusively dedicated to healthcare.


[1] Avalere Heath,ed. COVID-19’s Impact on Acquisitions of Physician Practices and Physician Employment 2019-2020. Physician’s Advocacy Institute. Published June 2021. Accessed January 31, 2022.

[2] Palmer W. What is the cost of starting a medical practice? Wolters Kluwer. Published February 7, 2021. Accessed January 31, 2022.

[3] Green J. How much EHR costs and how to set your budget. EHR in Practice. Published November 9, 2021. Accessed January 31, 2022.