Benjamin Franklin’s Junto,
Revisited

In 1727, a twenty-one-year-old printer named Benjamin Franklin gathered eleven friends in Philadelphia for what he called the Junto. The members were tradesmen — printers, surveyors, shoemakers, carpenters, a glazier — men who wore leather aprons to work and who understood, from direct experience, the practical difficulties of making a living in early America. They met every Friday evening to read essays, share knowledge, and ask each other a set of standing questions.

The questions were deliberately practical. Have you lately heard of any citizen’s thriving or suffering in business, and by what means? The Junto was not a philosophical society in the European tradition. It was a knowledge-sharing cooperative, built by people who needed information to make better decisions about their working lives.

Out of the Junto came institutions that reshaped Philadelphia and, eventually, the republic: the first public lending library in America, the first volunteer fire department, the American Philosophical Society, and what would become the University of Pennsylvania. Franklin later called the Junto the most useful undertaking of his life.

The Leather Apron Club, as it was sometimes called, operated on a conviction that is easy to overlook in its simplicity: that people who share relevant knowledge make better decisions than people who do not, and that labor markets function more fairly when the people doing the work understand the economics of what they produce.

A physician in modern American healthcare occupies an economic position with striking parallels to the members of Franklin’s Junto. They produce something of measurable value. That value is captured — aggregated, repackaged, and sold — by institutions with far greater access to information about the economics of the transaction than the physician possesses.

The hospital knows what it receives from each payer for each procedure performed by each specialist. The physician, in most cases, does not. The health system employs compensation analysts whose entire job is to understand the benchmarks being used in salary negotiations. The physician, alone at the table, works from survey data that is opaque, often outdated, and structurally biased toward perpetuating the status quo.

Junto Analytics exists to change this. We take the price transparency data that federal law now requires hospitals to disclose, combine it with physician productivity data from CMS, and make it queryable — so that the physician sitting across the table from a compensation committee knows, with specificity, what their work generates.

Physician compensation involves two prices. The first is what the institution receives from payers for each procedure. The second is what the institution pays the physician for the same work. Until recently, only one of these prices was visible to physicians.

The Hospital Price Transparency rules, which took full effect in 2021, have made the first price publicly available for the first time. This creates a new analytical possibility: the computation of yield — the ratio of what the physician produces for the system to what the system pays the physician.

Junto Analytics is building the infrastructure that turns this possibility into practice. Our tools make this analysis accessible to the physicians, administrators, researchers, and policymakers whose work depends on it.