Why I Chose Private Practice — And Why It Matters for Your Care
A message to my patients from Dr. Edward S. Rubin, MD
There is something happening in American medicine that not enough doctors talk about openly.
Over the past decade, large hospital systems and private equity-backed healthcare conglomerates have quietly acquired independent physician practices across the country. Today, more than 70% of physicians in the United States are employed by hospitals or corporate groups and not running their own practices. That number was below 25% just fifteen years ago.
I am not one of those 70%. And I want to explain why that matters to you.
What You Lose When Your Doctor Works for a System
When a physician is employed by a large health system, their priorities are divided. They answer to administrators, productivity metrics, and referral networks, not just to you. Appointments may get shorter as doctors have to focus on hitting useless chart metrics that boost payments. Schedules get tighter. The face you see changes visit to visit. The system will try to convince you that your doctor does not matter — just stick with the system.
In pain management specifically, this matters more than almost any other specialty. Chronic pain is complex. Your history, your imaging, your prior treatments, your goals all take time to understand. In a high-volume corporate practice, you don't always get that time and continuity of care. You just get passed around and have to teach your doctor what works for you.
I have seen patients come to me after years inside large systems, bounced between providers, handed prescriptions instead of diagnoses, told their pain was "weight related" or "normal for your age." That is not a care failure — it is a system failure.
What Private Practice Gives You Instead
When you come to my office in Garden City, you are not a number on a schedule. You are a patient I have chosen to care for personally. I do not take on everybody.
Private practice pain management means:
- You have access to me. Not a covering PA or MD. Every after-hours issue is mine — 24/7/365.
- I answer to you, not to a hospital's referral network or a corporate productivity target.
- I know your history. You are not getting the flavor-of-the-month physician.
- I have every incentive to get you better. My practice exists because my patients trust me, and my reviews and outcomes matter to me. That accountability drives better care.
The Honest Challenge
I won't pretend competing with large systems is easy. They control referral pipelines, insurance contracts, and marketing budgets that dwarf what a private practice can match. When a hospital system owns your primary care doctor, your orthopedic surgeon, and your imaging center, the referral to an independent specialist can be quietly redirected — not because it's better for you, but because it keeps revenue inside the network.
If your primary care physician is employed by a large system, ask them directly: "Is there any reason you're referring me within your network rather than to the best specialist for my condition?" You deserve an honest answer.
My Commitment to You
I built this practice on a single promise: the patient in front of me gets my full attention, my full training, and my genuine investment in their outcome. That is what independent medicine looks like.
If you are living with chronic or acute pain in Nassau County, Garden City, or anywhere on Long Island, I would like the opportunity to care for you the way medicine was meant to be practiced.
Call us at 516-492-3100 or request an appointment online.
Dr. Edward S. Rubin, MD is a board-certified pain management specialist and anesthesiologist in private practice in Garden City, NY. He is a Past President of the NY Society of Interventional Pain Physicians and an Assistant Professor at Hofstra/Northwell Medical School.