The proportion of patient care physicians who have an ownership stake in their medical practice dropped below 50%, marking the first time that physician practice owners did not comprise the majority since practice arrangement trends have been documented, according to a new study by the AMA.
“Patients benefit when physicians practice in settings they find professionally and personally rewarding, and the AMA strongly supports a physician’s right to practice in the setting of their choice,” Andrew W. Gurman, MD, president of AMA, said in a press release. “The AMA is committed to helping physicians navigate their practice options and offers innovative strategies and resources to ensure physicians in all practice sizes and setting can thrive in the changing health environment.”
The AMA used data from its Physician Practice Benchmark to evaluate the practice arrangements of physicians between 2012 and 2016. They found that physician ownership declined from 53.2% in 2012 to 47.1% in 2016, while the proportion of patient care delivered by physicians with employed positions increased from 41.8% in 2012 to 47.1% in 2016. Thus, in 2016, the proportion of physician employees and physician practice owners were equal. Independent contractors accounted for 5.9% of patient care physicians, according to the report.
Due to younger physicians preferring employed positions, 65.1% of physicians aged younger 40 years were employees in 2016, compared to 51.3% in 2012, according to AMA. The proportion of physicians aged 40 years and older who were employees also increased, though at a slower pace than younger physicians.
In 2016, there was a wide variation of owners, employees and independent contractors across medical specialties. The surgical and radiology subspecialties had the highest proportion of owners (59.3% and 56.3%, respectively). Emergency medicine physicians were least likely to be owners (27.9%), but most likely to be independent contractors (24.8%). Pediatricians accounted for the highest proportion of employed physicians (58.3%).
Most patient care physicians (55.8%) worked in medical practices wholly owned by physicians in 2016; however, this majority diminished from 60.1% in 2012, with most of this decline occurring between 2012 and 2014, according to the report. In 2014 and 2016, the proportion of physicians working directly for hospital or practices with some hospital ownership was the same (32.8%).
Though there were indications of a gradual shift towards larger practices of 50 or more physicians (13.8% in 2016 vs. 12.2% in 2012), more than half of physicians (57.8%) work in small practices with ten or fewer physicians, according to AMA.
Disclosure: Healio Internal Medicine was unable to confirm relevant financial disclosures at the time of publication.