The landscape of medical practice ownership is undergoing significant transformations, with the latest data from the American Medical Association (AMA) pointing to substantial shifts over the past decade. The recently released report, part of the AMA’s Policy Research Perspective series, delves into long-term changes in practice arrangements and payment methodologies, shedding light on the evolving dynamics within the medical field.
From 2012 to 2022, there has been a substantial decline in the share of physicians engaged in private practices. The figures show a notable 13-percentage point drop, equating to a 60.1% decrease in physicians working independently. In contrast, there has been a noticeable uptick in physicians aligning themselves with hospitals, either as direct employees or contractors. The proportion of physicians in this category rose from 5.6% in 2012 to 9.6% in 2022.
A deeper dive into the data reveals that the share of physicians affiliated with practices partially owned by hospitals or health systems has experienced a steady increase. In 2012, this figure stood at 23.4%, and by 2022, it had climbed to 31.3%. This suggests a growing trend of physicians becoming part of larger healthcare entities.
The evolving landscape also highlights changes in the size of medical practices. The proportion of physicians in small practices, defined as those with 10 or fewer physicians, saw a notable decrease from 61.4% in 2012 to 51.8% in 2022. In contrast, larger practices, defined as those with at least 50 physicians, experienced growth from 12.2% to 18.3% over the same period. Midsized practices, with 11 to 49 physicians, remained relatively stable during this timeframe
This shift in practice ownership and size indicates a broader trend in the way physicians structure their professional affiliations. Factors such as economic considerations, regulatory changes, and responses to the challenges posed by the COVID-19 pandemic may be influencing these transformations. Physicians seem to be gravitating towards larger entities, potentially seeking stability, resources, and support in navigating the complexities of modern healthcare.
The AMA’s Physician Practice Benchmark Surveys, which form the basis of this analysis, provide a nationally representative snapshot of post-residency physicians. The surveys encompass physicians providing a minimum of 20 hours of patient care per week, excluding those employed by the federal government, and include responses from across the 50 states and the District of Columbia. The latest survey, conducted from September to November 2022, garnered responses from 3,500 physicians, with a response rate of 31%. This comprehensive dataset illuminates the changing landscape of medical practice ownership, offering insights into the ongoing evolution of healthcare delivery structures.