Living in the Past: The Corporate Practice of Medicine Doctrine’s Misguided Revival in an Era of Private Equity

This comment argues that the recent revival of the corporate practice of medicine (CPOM) doctrine as a tool for limiting private equity (PE) involvement in healthcare is misguided and ill-suited to the realities of the modern healthcare system. After tracing the development of the CPOM doctrine from its origins in early twentieth-century concerns about corporate interference with physician autonomy, the comment examines the rise of healthcare corporatization, the growth of PE investment, and the widespread use of management services organization-professional corporation structures. The author reviews recent litigation and the wave of state legislation enacted or proposed in 2025, including laws in Maine, Oregon, and California that seek to restrict PE ownership, prohibit certain corporate arrangements, or strengthen prohibitions on non-physician influence over clinical decision-making. The comment contends that contemporary efforts to revive the CPOM doctrine rest on flawed assumptions about PE and overlook broader structural challenges facing healthcare providers, including consolidation, declining financial stability, reimbursement pressures, and rural hospital vulnerability. It argues that many concerns attributed to PE, such as cost-cutting, market concentration, and financialization, are not unique to PE-owned entities and are also present among nonprofit and other healthcare organizations. The author further maintains that modern CPOM laws may produce unintended consequences by reducing access to capital, discouraging investment in struggling providers, accelerating consolidation by large health systems, and limiting opportunities for independent physician practices. Rather than relying on an antiquated doctrine designed for a markedly different healthcare environment, the comment advocates owner-neutral regulatory approaches, including transaction review requirements, antitrust enforcement, and targeted restrictions on harmful business practices. The comment concludes that policymakers should focus on systemic healthcare reform and financial sustainability rather than attempting to curb healthcare corporatization through a revived CPOM framework. [This abstract was written by Microsoft Copilot, a generative artificial intelligence.]