AMA: Physicians in independent practice now minority in US

Dive Brief:

  • Last year marked a historic shift in the organization of medicine, with fewer than half of U.S. doctors working in a private practice, according to the latest American Medical Association Physician Practice Benchmark Survey. And among those private practices that continue to operate, many are trending toward a larger size.
  • According to the report, 50.2% of physicians were employees, up from 47.4% in 2018 and 41.8% in 2012. The proportion of doctors working in a private practice was 49.1% last year.
  • Hospitals are one of the largest employers of physicians, with the proportion increasing nearly 50% between 2012 and last year. And with the vast majority of doctors under the age of 40 now employees rather than employers, it suggests the trend will continue over the long term.

Dive Insight:

There has been ongoing debate in recent years about physician burnout, with much of it attributed to their having to balance the administrative tasks of running a practice with caring for patients. Now, it appears that practicing as an employee is taking over.

Among the cohort of doctors working for someone else, 56.5% are women and fully 70% are under the age of 40.

Medical specialty also tended to dictate whether a physician stayed in an independent practice or worked as an employee. Some 58% of pediatricians were employed, compared to less than 40% of specialty surgeons and radiologists.

Twenty percent of physicians worked for medical groups owned by hospitals, while 9% worked for hospitals directly and 8.2% were employed by practices owned by other physicians.

Meanwhile, the size of existing medical groups grew significantly. The proportion of doctors working in medical groups with 10 or fewer doctors was 53.7%, compared to 56.5% in 2018 and 61.4% in 2012. Among that cohort, more than 60% are over the age of 55. At the same time, the proportion of physicians in practices with 50 or more doctors grew from 12.2% in 2012 to 17.2% last year.

Among all practices surveyed by the AMA, 4% were owned by private equity firms. Among anesthesiology and emergency medicine practices, the proportion of ownership by private equity firms ranged between 10% and 15%.