If there's anything that physician entrepreneurs have in common, it is a sense of optimism about their endeavors and a real need to understand how the future will affect them.
The closing roundtable at the inaugural AMA Physician Entrepreneur Forum held in Chicago last month brought together three experts whose combined experience and expertise made them more than qualified to discuss just that.
They were:
- Rushika J. Fernandopulle, MD, CEO of Liza Health, an AI-based primary care platform.
- Daniel J. Durand, MD, chief medical officer and president of the medical group at Prenuvo, a proactive health care company.
- Vasanth Kainkaryam, MD, MS, founder of 4 Elements Direct Primary Care & Wellness Space.
The AMA Physician Entrepreneur Forum is part of the AMA Career Advancement Collective, a powerful new suite of educational programs and training that helps physicians develop and advance at every stage of their career.
The panelists touched on a wide range of topics, but three in particular invited the most discussion, excitement and consensus among them: independence and ownership, technology, and patient-centered care models.
Dr. Durand best expressed the mood of the room, the attendees, his fellow panelists and the AMA Physician Entrepreneur Forum itself.
“I feel enthusiastic about us as a professional class taking more ownership and risks and having more skin in the game than we have in the past 30 years,” he said.
Shift toward independence, ownership
Dr. Fernandopulle sees a return to self-determination as a reaction to physicians surrendering too much control to health systems, administrators and technology companies. He recounted his own experience with a physician colleague who was recruited by a tech giant that, in the end, valued him only for his medical license. This colleague approved decisions and the organization was able to maintain regulatory compliance, but nonphysicians remained in control.
“Six months later, he calls me and says, ‘Rushika, I hate it here. The hoodies are running the show,’” he said, quoting his friend referencing a term for the casual hooded-sweatshirt attire seen in many startups. “I think there's a lot of that going on.”
Dr. Durand was the most explicit in predicting a dramatic return to private practice for many physicians, with conditions emerging that will allow patient-facing physicians in particular to move away from employment by large organizations and once again own and control their own workplaces.
“Physicians uniquely understand what it’s like to have to make some of the most difficult decisions on behalf of other human beings, and that’s what excites me about more and deeper physician ownership.” Dr. Durand said.
Technology will cut barriers
Niche physician practices will grow and thrive thanks to augmented intelligence (AI) and technology that helps establish smaller practices without the infrastructure that larger organizations require, Dr. Kainkaryam predicted.
“At this point, technology, clinical knowledge and business are democratized,” he said, and while technology will enable the small practice, it won't distinguish it. “What’s really going to set physician entrepreneurs apart is what the patient experience and journey look like.”
Physicians must make new technology serve them instead of allowing it to dictate how they practice, panelists said. They will be free to embrace their uniquely human talents, such as clinical judgment, understanding medicine’s real-world complexities and ethical obligations to patients, further elevating the trust that those patients place in them.
“It’s not just knowledge. If it were, [OpenAI Chat] GPT-5.0 could do our jobs,” Dr. Fernandopulle said. “It’s actually about judgment, wisdom, our ability to understand subtlety, and this moral code that is the real source of our power.”
While AI cannot replace the profound human traits that give physicians their true value, it can remove some of the technological and administrative barriers that constrain them.
“I think we’ll see the rise of platforms that allow physicians to either operate with greater autonomy or rely on shared infrastructure and administrative support that makes it easier to start a health technology business or a small private practice,” Dr. Durand said. “You can have back-office functions like AI-automated revenue cycle and prior authorization processes, but what won’t be commoditized is what’s in this room: The context, the trust and the license.”
Organizing care around patients
Dr. Kainkaryam said that successful physician entrepreneurship will revolve around connecting physicians and patients through specific—and potentially competing—patient-driven models, including membership-based models funded by individuals or self-funded employers. As traditional technological and business practices become ubiquitous, physician entrepreneurs will need to build relationships around what patients want in terms of how they experience care.
“We see a lot of consumers saying, ‘Hey, I want a holistic approach,’ which is sort of contradictory to ‘niche,’” he said. “It will be interesting to see how these ultimately play out, but I think that one of those two is where a lot of these new businesses are going to come from.”
Physicians must ally themselves with patients and organize those relationships in such a manner that the focus is on directly solving their problems and avoiding, as much as possible, specialty silos.
“A patient actually doesn’t care if it’s a cardiology, primary care or EP [electrophysiology] problem. They want us to fix it,” said Dr. Fernandopulle. “We’ve gone down this path of selling people more stuff. But what if we say, ‘Now we’re going to help keep you from having a stroke or a heart attack in the first place?’”
The key to making that work, he said, is preserving patient trust in physicians and ensuring that their economic incentives align with patients' interests. Instead of delivering more services, physician entrepreneurs should focus on outcomes, sometimes in collaboration with different disciplines outside their own and the structures of the existing healthcare system.
Dr. Durand also sees direct relationships with patients as a path toward greater physician independence, particularly by reducing reliance on the payers and organizations that often stand between doctors and those they serve.
“If you build a niche practice, like primary care or a concierge service, you don’t need someone negotiating for you because you’re delivering care directly to the patient,” he said.
Technology can make those relationships easier to establish and support, while consumer demand could encourage development of new platforms built around them.
“Consumer medicine could be a huge driving force for creating platforms where physicians can engage directly with patients,” Dr. Durand added.
New businesses will be built around direct relationships with those patients rather than controlled by the organizations and payment structures that have come to define current medical practices.
“I do think the pendulum is going the other way,” Dr. Durand said. “I don't think there will ever be a better time to be an independent businessperson and a physician than in the next 10 years.”
