The American Medical Association says financial and administrative pressures on physicians are driving the shift away from independent practices.
Physicians are less likely to work in private practices than they were a decade ago, according to a new Physician Practice Benchmark Survey conducted by the American Medical Association (AMA).
The AMA launched its first Physician Practice Benchmark Survey in 2012. The surveys, which are published every other year, are nationally representative of post-residency physicians who provide at least 20 hours of patient care per week. The latest survey, which was conducted from September to November 2022, features data collected from 3,500 physicians.
The results of the latest survey reflect financial and administrative pressures on physicians, AMA President Jesse Ehrenfeld, MD, MPH, said in a prepared statement.
"The AMA analysis shows that the shift away from independent practices is emblematic of the fiscal uncertainty and economic stress many physicians face due to statutory payment cuts in Medicare, rising practice costs, and intrusive administrative burdens. Practice viability requires fiscal stability, and the AMA's Recovery Plan for America's Physicians is explicit in calling for reform to our Medicare payment system that has failed to keep up with the costs of running a medical practice."
The Physician Practice Benchmark Survey released yesterday has several key data points in four areas.
1. Practice ownership
- From 2012 to 2022, the proportion of physicians who work in private practices fell from 60.1% to 46.7%
- From 2012 to 2022, the proportion of physicians who work in a hospital-owned practice increased from 23.4% to 31.3%
- In most specialties in 2022, the proportion of physicians in private practice ranged from 41.2% for general surgeons to 49.7% for radiologists
- In 2022, the specialty outliers for physicians in private practice were emergency medicine physicians at 37.0% and surgical subspecialists at 63.3%
- The primary reason cited for hospital and health system acquisition of physician practices was the need to negotiate higher payment rates with payers, with 46.1% of survey respondents saying this reason was very important and 33.4% saying this reason was important
2. Practice size
- From 2012 to 2022, the proportion of physicians working in practices with 10 or fewer physicians decreased from 61.4% to 51.8%
- From 2012 to 2022, the proportion of physicians working in practices with 5 to 10 physicians decreased from 21.4% to 19.0%
- From 2012 to 2022, the proportion of physicians working in practices with fewer than 5 physicians decreased from 40.0% to 32.8%
- From 2012 to 2022, the proportion of physicians working in practices with at least 50 physicians increased from 12.2% to 18.3%
3. Practice type
- In 2022, single-specialty practices represented the largest proportion of physicians (41.8%) followed by multi-specialty group practices (26.7%), solo practices (12.9%), and a direct employment or contracting relationship with a hospital (9.6%)
- Over the past decade, the proportion of physicians in multi-specialty practices and a direct employment or contracting relationship with a hospital have increased about 4 percentage points
- Over the past decade, the proportion of physicians in solo practices and single specialty group practices has decreased about 4 percentage points
- At more than 50% of physicians in 2022, obstetricians/gynecologists, anesthesiologists, and radiologists had the largest proportion of physicians who practice in single specialty practices
- At 27.8% of physicians in 2022, general internists were least likely to work in a single specialty practice
- Psychiatrists and general internists were the most common specialties working in solo practices in 2022 at about 22% of physicians
4. Employment status
- In 2022, 49.7% of physicians were employees and 44.0% were practice owners
- In 2012, 41.8% of physicians were employees and 53.2% of physicians were practice owners
Related: AMA Data: Physicians in Private Practice Continue to Decline
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
From 2012 to 2022, the proportion of physicians who work in a hospital-owned practice increased from 23.4% to 31.3%.
From 2012 to 2022, the proportion of physicians working in practices with fewer than 5 physicians decreased from 40.0% to 32.8%.
From 2012 to 2022, the proportion of physicians who were employees rather than practice owners increased from 41.8% to 49.7%.