Requiring all surgeries to be referred to in-house dermatologic surgeons: Is it ethical or a profit haven?

There has been a trend in the United States of consolidation and corporatization of solo and small practices into larger groups. Many of these larger groups are owned by either hospital consortiums or private equity. Such larger practices often have their own Mohs surgeon to whom general dermatologists within these corporatized dermatology practices have been mandated to refer surgical patients. The ethics of these requisite referrals raises concerns about physician autonomy and whether patient care or profit is the primary motivator.