The era of "private practice" is waning fast, and actually is almost over. Most primary care MD's/DO's these days work for corporations punching a clock. Their practice parameters are usually/sometimes set by their non-physician supervisory people, including whether or not they can do Basic Med exams. Most of these corporations are very risk-averse and usually (not always) are not inclined to let their employed physicians determine whether or not a given patient is medically fit to fly an airplane. Likewise, some malpractice carriers around the country prohibit Basic Med exams for physicians under their coverage. The FAA medical branch actually has employed some reasonably plausible arguments regarding Basic Med physician liability, and many physicians take that seriously enough to just say no to Basic Med. Most doctors are so busy that they don't "have" to do anything that even hints of being potentially problematic, especially in the liability arena.
From Becker's Physician Leadership
"Here are three major companies dominating physician employment:
CVS Health
CVS Health
supports more than 40,000 physicians, pharmacists, nurses and nurse practitioners. The company
has 1,100 MinuteClinic locations in 36 states and Washington, D.C., and through its deal with Oak Street Health, CVS Health has more than 130 primary care clinics.
HCA Healthcare
HCA Healthcare
supports 38,000 physicians. The healthcare giant consists of 184 hospitals and about 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 21 states and the United Kingdom.
Optum
With 90,000 physicians in its portfolio, UnitedHealth Group's Optum is the largest
employer of physicians in the U.S. Optum
has 2,200 primary and specialty care offices in 16 states."
The growing lack of physician autonomy and increasing bureaucratic demands of time is what led me to semi-retire and close my private solo practice in 2010. Up side much less stress and more time for airplanes. Downside, I really miss being able to have long term relationships with patients. Any competent FP or IM doctor is able to do a BasicMed exam. Its the perceived risk, hassle, and ignorance of the process that prevents it being done if the employer allows. We are in an era of factory medicine now,