Shifts away from physician-owned practices continued in 2020, with the share of physicians in private practices dropping below 50 percent for the first time since the American Medical Association began measuring the metric in 2012, according to the latest analysis released May 5 by the AMA.
The analysis is based on the AMA's latest Physician Practice Benchmark Survey involving 3,500 U.S. physicians. Data for the latest survey was collected from September to October 2020, roughly six months into the COVID-19 pandemic. Therefore, it may not reflect full pandemic effects related to physician practice arrangements, the AMA said. A business structure component was added to the latest survey.
Six survey findings:
1. Nearly half of physicians (49.1 percent) worked in physician-owned practices last year, compared to 54 percent of physicians in the 2018 AMA survey.
2. The share of physicians in practices with at least 50 physicians was 14.7 percent in 2018 compared to 17.2 percent last year.
3. More than half of physicians (50.2 percent) were employed in 2020, while 44 percent were self-employed.
4. About 40 percent of physicians worked either directly for a hospital or for a practice with at least partial hospital or health system ownership last year, up from 34.7 percent two years earlier.
5. Most physicians in 2020 (53.7 percent) still worked in small practices of 10 or fewer physicians.
6. Limited liability companies (27.8 percent) and S corporations (24.7 percent) are business structures that accounted for more than 50 percent of physicians in private practice.
The AMA attributed the ongoing shifts in practice size and ownership to contributing factors such as mergers and acquisitions, practice closures, physician job changes, and the different practice settings chosen by different age groups.
AMA President Susan Bailey, MD, said in a news release: "To what extent the COVID-19 pandemic was a contributing factor in the larger than usual changes between 2018 and 2020 is not clear. Physician practices were hit hard by the economic impact of the early pandemic as patient volume and revenues shrank while medical supply expenses spiked. The impact of these economic forces on physician practice arrangements is ongoing and may not be fully realized for some time."
Access the full survey findings here.