Nearly two years ago, our group left health system employment to build an independent cardiology practice.
Since then, one lesson has become increasingly clear: independence is about maintaining control—not managing every function yourself. Modern cardiology requires sophisticated infrastructure—revenue cycle expertise, recruiting, payer support, technology, analytics, capital, and the ability to develop new services.
For many cardiologists, some form of partnership will increasingly make sense.
The more important question is what kind of partnership you are entering, and what that means for the future of your practice.
Two Different Paths to Scale
Private equity has become one option for cardiology groups looking for capital, operational resources, and scale. Another approach is a physician-led model, where an operating partner provides the infrastructure and expertise needed to grow while physicians remain closely involved in ownership and direction.
Both models can provide resources. But what happens after the partnership begins can look very different.
| Private Equity | Physician-Led Model |
| Investor-led | Physician-led |
| Built to generate investment returns | Built to strengthen the practice |
| Ownership and control can shift | Physicians retain ownership and influence |
| Growth increases platform value | Growth builds practice value |
| Decisions balance practice and investor priorities | Decisions center on the practice |
| Typically tied to an investment timeline | Built for long-term independence |
| Capital + management | Infrastructure + operating support |
That distinction is important.
Private equity is fundamentally an investment model. Capital is deployed with the expectation of generating a return, and there is typically a financial lifecycle associated with that investment.
A physician-led model starts from a very different place. The objective is to give physicians the resources of a larger organization while preserving their ability to shape the practice they are building.
Clinical Autonomy Is Only Part of the Equation
Most physicians considering a partnership ask whether they will maintain clinical autonomy. They should.
But after two years in private practice, I believe practice autonomy is just as important.
Who decides when it is time to recruit another physician? Whether to open another location? Which technology is worth investing in? Which service lines make sense for the patient population? Where should capital be deployed?
Those may look like business decisions, but they directly affect how physicians practice medicine and how they care for their patient populations.
The structure of the partnership determines how much influence physicians continue to have over those decisions.
What This Has Looked Like for Us
Our group did not want to recreate the administrative burden of running a traditional private practice entirely on our own. We wanted the infrastructure to compete at scale without returning to an employment model, with CardioOne supporting much of that infrastructure.
In less than six months, we launched a new practice with 12 providers, recruited and trained more than 50 employees, opened two locations, completed payer enrollment, and established the clinical and operational capabilities needed to begin seeing patients.
Since then, the practice has continued to grow. Our patient base expanded from approximately 6,700 to more than 17,000, and we developed capabilities across advanced imaging, cardiac rehabilitation, rhythm monitoring, remote patient monitoring, care management, and other cardiovascular services.
Within our first year, the practice also reached a collections-per-provider run rate above the 75th percentile of MedAxiom benchmarks.
Those results required significant operational support. But importantly, that support was designed to help build our practice, not replace physician leadership within it.
Scale Should Strengthen Independence
Cardiology is becoming more complex and capital intensive. Practices need capabilities that would be difficult for most physician groups to build independently.
That does not mean physician ownership has become obsolete.
It means the model of independent practice has to evolve.
Physicians should be able to access professional management, technology, purchasing leverage, analytics, capital, and operational expertise without automatically giving up the ability to determine where their practice goes next.
As we approach our second anniversary, that may be the biggest takeaway from our experience.
The question is no longer whether independent cardiologists need scale. They do. The question is whether that scale is being built around the physicians—or around the investment.