15 key findings on physician practice arrangements

A new study from the American Medical Association revealed physician practice arrangement trends may be moving more slowly than we think. Even amidst changes to the healthcare landscape over the last few years, most physicians have continued to work in small, physician-owned practices, according to the study.

"These data show that the majority (60.7 percent) of physicians were in small practices of 10 or fewer physicians, and that practice size changed very little between 2012 and 2014 in the face of profound structural reforms to healthcare delivery," AMA President-elect Andrew W. Gurman, MD, said in a statement.

Though there have been dramatic changes in physician practice arrangements over the past 30 years, short-term changes show physicians are gradually moving to hospital ownership.

Here are 15 key findings from the study.

Physician ownership and practice arrangements

  • The percentage of physicians who worked in wholly physician-owned practices in 2014 (56.8 percent) decreased slightly from 2012 (60.1 percent).
  • Physician practice ownership decreased between 2012 (53.2 percent) and 2014 (50.8 percent). These changes are more pronounced in the long term. Physician practice ownership has declined significantly from 1983, when it was 76.1 percent.
  • The percentage of solo-practitioners decreased from 2012 (18.4 percent) to 2014 (17.1 percent). This share has fallen from more than 40 percent of physicians in 1983.
  • Single-specialty practice remains the most common type of physician practice, with 42 percent of physicians in this type of practice in 2014, though it has declined from 45.5 percent in 2012.
  • Multispecialty practices are growing — the share of physicians in this type of practice increased to 25 percent in 2014 from 22.1 percent in 2012.

Practice size

  • Practice size hardly changed between 2012 and 2014. The only statistically significant change was in practices of two to four physicians, which increased two percentage points from 2012 to 22.3 percent.
  • 20 percent of physicians were in practices of five to 10 physicians in 2014, 13.5 percent were in practices of 50 or more physicians, 12.1 percent were in practices of 11 to 24 physicians, and 6.3 percent were in practices of 25 to 49 physicians.
  • In general since the 1980s, physician practice size has increased, due mainly to the decline in solo practice. And as practice sizes grow, so do the number of physician employees, explaining the decline in physician ownership, according to the report.

Hospital ownership and employment

  • Physicians who were hospital-employed or their practices had some hospital ownership increased slightly to 32.8 percent in 2014 from 29 percent in 2012.
  • Direct hospital employment increased to 7.2 percent in 2014 from 5.6 percent in 2012.
  • Physicians in practices with some hospital ownership increased between 2012 (23.4 percent) and 2014 (25.6 percent).

Gender and age

  • A greater share of male physicians were owners of a practice in 2014 (54.9 percent) than women (42.1 percent).
  • The gender gap in employment for physicians under age 40 narrowed to 6 percentage points in 2014, from 22 percentage points in 1983.
  • Slightly more than 30 percent of men under age 40 were employees or independent contractors in 1983 and 51.9 percent of women under age 40 were employees or contractors. In 2014, the employment grew, but the gap narrowed so that 63.3 percent of men under age 40 were employees or independent contractors compared to 69.1 percent of women.
  • Among all ages, 57.9 percent of women are employees or independent contractors, compared to 45.1 percent of men.


More articles on integration and physician issues:

3 physicians from America's tiniest towns talk patient relationships, rural practice and the state of healthcare
University of North Texas announces medical school partnership
What physicians want in a practice setting

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars