The consolidation of physician practices is a well-known phenomenon across medicine, predominantly attributed to financial, legal, and regulatory hurdles confronted by practitioners.1-3 Practices, including those owned and operated by anesthesiologists, can be acquired by hospitals and health care systems, private equity (PE) investors, and practice management groups.4-7 There are numerous effects of this trend on health care costs, patient care and satisfaction, and physician well-being and stability.8,9 Consolidation may follow many different pathways, but geographic monopolization is a frequent end result.
Geographic monopolization occurs when a group of physicians or a health care system provide the only available services for a particular area. This has been very common, particularly in hospitals and large health care systems that acquire or merge with other entities to reduce costs, leveraging capital and resources by improving efficiencies so they can align services to consolidate referrals for specialty care to improve access...