Only 23% of Employed Physicians Report a Great Deal of or Complete Control Over Patient Volume. Independents Report Twice That.

Fewer than one in four employed physicians report a great deal of or complete control over how many patients they’re expected to see. Among independent physicians, the figure is 49%.

That gap comes from The Physicians Foundation’s 2026 Survey of America’s Physicians, run with Medscape in August 2026 among 1,000 physicians and released Sept. 17. It got a second airing on Oct. 20, when foundation president Gary Price, MD, told Medical Economics that misinformation, burnout and eroding trust are “incredibly interrelated.”

If you’re weighing direct primary care, the survey earns a close read for one reason. It separates two things the DPC pitch tends to bundle together: control over the schedule, and relief from pressure. Independent physicians report far more of the first. On the second, they report a different mix.

The autonomy gap, by the numbers

Across all respondents, 74% said they have a great deal of or complete control over clinical decisions about patient care. Only 31% said the same about the number of patients they’re expected to see. For time spent with patients, it was 37%.

Split by employment setting, the gap widens:

• Patient volume: 49% of independent physicians report a great deal of or complete control, against 23% of employed physicians.
• Time with patients: 51% of independents, against 31% of employed physicians.
• Time away from work: 55% against 40%.

The distress figures run the same direction. 62% of employed physicians felt debilitating stress in the past year, compared with 51% of independents. And 34% of employed physicians identified “organizational policies, productivity expectations, or internal pressures that limit clinical autonomy” as a contributor to their distress. Among independents, 13% did.

Age matters too. Only 24% of physicians aged 45 or younger report that level of control over patient volume, against 35% of those 46 and older. A resident about to sign a first contract is joining the younger cohort.

What independence costs

The same report shows independents carry pressure that employed physicians mostly don’t.

Nearly half of independent physicians, 49%, identified administrative burdens “including prior authorization, documentation, and other insurance requirements” as a top contributor to distress. Among employed physicians, it was 39%. Financial pressure affecting the practice, compensation or job stability was named by 37% of independents. That’s more than twice the 16% of employed physicians.

So the trade shows up in the data. An employed physician hands the business to someone else and gives up much of the schedule. An independent physician keeps the schedule and takes on the business, including the insurance paperwork that comes with billing payers.

Price’s comment on time with patients was about large consolidated institutions in general. He told Medical Economics, “These big consolidated institutions don’t necessarily focus on making sure the patient has time with a physician to have the discussions that build trust.”

Where DPC sits in this survey

The published findings don’t break out payment model. By practice setting, the report splits respondents only into employed and independent physicians, with no DPC category. Nothing here measures DPC physicians’ wellbeing directly, and the independent column shouldn’t be read as a stand-in for them.

What the model does change is the mix of the two pressures independents named. A DPC practice typically doesn’t bill insurance, and AAFP notes it has no need to fund insurance billing and coding support. AAFP also lists reduced administrative burden among the model’s benefits to physicians. The American Academy of Family Physicians puts the average DPC panel at about 413 patients, with monthly fees that generally range from $50 to $100.

The financial pressure stays put. Multiplying AAFP’s averages gives a rough sense of scale: a 413-patient panel at $50 to $100 a month works out to roughly $20,650 to $41,300 in monthly membership revenue before a single expense. That’s arithmetic on two averages, not a reported figure, and every dollar of it depends on members renewing.

One note on the source. The foundation’s press release says 67% of employed physicians reported inappropriate feelings of anger, tearfulness or anxiety in the past year. The full report page gives 62% for the same measure. Both list 54% for independents. This post cites the report page, which is the fuller document.

The tension the model lives inside

The survey’s sharpest split runs between who controls the schedule and who carries the risk. Employed physicians report less control and are less likely to name financial pressure as a source of distress. Independents report more control and name financial pressure far more often.

DPC typically takes insurance billing off the independent side of that ledger. The risk stays with the owner. 42% of physicians in the survey said that, because of concerns about their wellbeing, they had considered or taken steps toward reducing their clinical hours or the number of patients they see. In a membership practice, what changes is who pays for a smaller panel: the practice itself, one renewal at a time.