Transition from Resident to Attending

Is private practice really giving way to hospital ownership?


Although a common perception is that hospital ownership of practices is skyrocketing even as the number of physicians in small practices is shrinking, newly released data tell a far less dramatic story.

A new AMA report looked at both short- and long-term changes in physician practice arrangements using data from the most recent AMA Physician Practice Benchmark Survey, finding that growth in hospital ownership has been slow while most physicians still provide care for patients in small practices.

The number of physicians in small practices with 10 or fewer physicians remained the majority at 60.7 percent. And 56.8 percent of physicians worked in practices wholly owned by physicians, only a slight decrease from 2012, when 60.1 percent of physicians worked in physician-owned practices.

The share of physicians who worked directly for a hospital or in practices that had at least some hospital ownership, meanwhile, increased modestly from 29 percent in 2012 to 32.8 percent in 2014.

The report delves into four aspects of physician practice arrangements:

  • Whether physicians are owners, employees or independent contractors with their main practice
  • What type of practice best describes their main practice (including solo, single specialty, multi-specialty, direct hospital employee and faculty practice)
  • What the ownership structure of their main practice is
  • How many physicians are in their main practice

Additional insights from the report include:

  • Younger physicians were more likely than older physicians to be employed. About 59 percent of physicians under the age of 40 were employed, versus 46.0 percent of physicians aged 40-54 and 33.3 percent of physicians 55 and above.
  • Nearly one-third of physicians are in practices with more than 10 physicians, including 13.5 percent in practices with 50 or more physicians.
  • Multi-specialty practice physicians were more likely than single-specialty practice physicians to report that their practices were hospital owned—44.6 percent compared to 23.0 percent.

“The AMA is committed to ensuring physicians in all practice sizes and types can thrive and offers innovative strategies and resources that address common practice challenges in the new health environment,” AMA President-elect Andrew W. Gurman, MD, said in a statement about the report.

No matter what your practice type or size, the AMA has resources to make your practice thrive: