Independent physician practices in the U.S. have been disappearing as hospitals and larger health systems acquire more and more of them, turning doctors into employees instead of owners of healthcare practices. For patients and the U.S. healthcare system as a whole, this has led to rising expenditures without commensurate improvements in the quality of care. Reforms should be undertaken to restore independent physician practices, which would provide a needed competitive boost to the health system, improve patient care, and lower expenses.