New Survey: Independent Primary Care is Resilient; Navigating Financial Strain Without Walking Away
Independent primary care is being squeezed from every angle. Financial pressure is rising. Reimbursement remains a top concern. Staffing, technology, and overhead continue to strain already-thin margins. But new survey data from Elation Health shows something important: physicians are not giving up. They are adapting, innovating, and building more sustainable paths forward.
Elation’s first-ever Primary Care Pulse survey gathered responses from 280 primary care clinicians actively using the Elation Health platform. The findings paint a clear picture of a market in transition. More than 8 in 10 clinicians said they are concerned about their long-term financial sustainability, with reimbursement from government and commercial payers cited most often as the top source of pressure.
Financial strain is real — but so is physician resilience
The survey results point to a profession under real strain. More than 80% of respondents are worried about financial stability over the next several years, and many said those pressures are limiting practice viability and investment in patient care. Protecting financial stability emerged as the most important priority, followed closely by preserving work-life balance.
And yet, the dominant story here is not retreat. It is resilience.
While a recent national survey found that 44% of physicians are considering leaving primary care, only 2% of Elation respondents said they had similar plans. Instead of walking away, many physicians are rethinking how their practices operate. Among insurance-taking physicians, 27% said they have added membership or cash-pay models, and another 18% have adopted value-based payment structures. Another 69% said they are actively developing plans to address financial concerns through changes like new payment models, locations, or care offerings, and 67% of those expect those changes to take effect within two years.
As Dr. Sara Pastoor, head of primary care advancement at Elation Health, put it, independent physicians are not waiting for the system to change. They are already taking action to protect both the sustainability of their practices and the quality of their lives in medicine.
AI is becoming part of the sustainability equation
The survey also highlights a second major theme: AI is quickly becoming part of how primary care practices stay strong.
More than half of respondents — 58% — said AI is essential to the future of primary care. More than 65% of respondents already use AI tools, and among that group, 98% reported positive impact. The top benefits were practical and immediate: 72% reported reduced documentation time, and 35% said AI helped lower burnout.
That matters because physician engagement remains one of primary care’s most valuable assets. In the survey, 80% of physicians said they feel joy in their work daily or throughout every week, and 93% said they remain committed to primary care despite sustainability concerns. Technology alone is not the answer — but when it reduces burden and supports better workflows, it can help create the conditions physicians need to keep doing meaningful work.
A different future for independent primary care
One of the most compelling takeaways from the data is that consolidation is not the only path forward. Elation’s survey points to a growing segment of independent, entrepreneurial primary care clinicians who are building financially sustainable practices on their own terms.
That finding is especially notable given the makeup of respondents. 69% reported practicing for more than 11 years, and 52% said they are completely unaffiliated with any health system, IPA, CIN, or ACO. These are experienced clinicians making deliberate decisions about how they want to practice medicine—and what they need from technology and operations to make that possible.
As Kyna Fong, CEO and co-founder of Elation Health, said, primary care works best when clinicians can put patients first without undue distraction or burden. That requires operational and financial support that is predictable, streamlined, and aligned with how physicians choose to care for their patients.
The bottom line
Independent primary care physicians are facing serious headwinds. But this survey makes one thing clear: many are meeting the moment with creativity, determination, and a willingness to redesign the business of care.
That is good news for the future of primary care — and for the clinicians committed to protecting it.
Read the report and see how Elation can help
Want the full findings from Elation’s Primary Care Pulse survey? Review the complete survey results report and learn how Elation supports modern primary care with a clinical-first EHR and billing technology built to reduce burden and support sustainable growth.