The AMA’s biannual practice survey shows that the proportion of physicians who have an ownership stake in their own practices fell to 47.1 percent in 2016. The survey included 3,500 U.S. physicians who provide ≥20 hours of patient care per week and are not employed by the federal government. These rates have been declining in recent decades, from 76.1 percent in 1983 to 53.2 percent in 2012 and 50.8 percent in 2014.
The survey also found that hospital acquisitions of practices have stalled, with the number of physicians directly employed by hospitals or hospital-owned practices remaining steady from 2014 through 2016, at 32.8 percent. This was up slightly from 29 percent in 2012.
“Despite challenges posed by a changing health-care landscape, most physicians (57.8%) provide care to patients in small practices of ≤10 physicians,” the report’s authors wrote. “There were signs of a gradual shift toward larger practices: In 2016, 13.8 percent of physicians were working in practices with ≥50 physicians, compared [with] 12.2 percent in 2012.”
Hospital ownership appeared to be more prevalent in primary-care practices, as nearly 33 percent of primary-care physicians (PCPs) in single-specialty groups reported working for hospitals, compared with 16.5 percent of non-PCPs.
A slight majority of physicians (55.8%) worked in practices owned by doctors in 2016, with 69 percent working in single-specialty practices and 36.7 percent working in multispecialty groups. Overall, single-specialty groups declined from 45.5 percent in 2012 to 42.8 percent in 2016. Multispecialty groups, however, increased from 22.1 percent in 2012 to 24.6 percent in 2016.
Doctor demographics also influenced employment statistics. Older doctors were more likely to own their practices, whereas younger doctors were more likely to hold employed positions (ownership ranged from 27.9% at ≤40 years to 54.9% at ≥55 years), and male doctors were more likely to have an equity stake in their practices (52.2%), compared with female physicians (36.6%).
Sources: American Medical Association, “Policy Research Perspectives: Updated Data on Physician Practice Arrangements: Physician Ownership Drops Below 50 Percent,” May 31, 2017; American Medical Association press release, May 31, 2017.