Profile of Physician Practice Arrangements

Trends in physician practice arrangements are detailed in a report on the latest 2007-2008 Physician Practice Information survey conducted by the American Medical Association in collaboration with over 40 national medical specialty associations. The survey provides data on:

• Practice ownership – When the survey was completed several years ago, 61% of physicians were self-employed, 34% were employed by others, and 5% were independent contractors. Of note, about 70% of physicians age 55 and older were self-employed, but just under half of age 40 and younger physicians were self-employed.
• Physician employment — 14% of all physicians were employed in office-based settings while 21% were institutional employees.
• Office-based practice sizes — Three-quarters of all physicians owned or were employed in an office-based setting. A quarter worked in solo practices, 21% in practices with 2-4 physicians, 13% in practices with 5-9 physicians, 12% with 10-49 physician practices, and 5%  in practices of 50 or more physicians.

A more recent study by Accenture indicates independent physicians have been declining by 2% a year, and it forecasts a 5% annual decline through 2013, leading to only one-third of physicians in independent practice. A Medical Group Management Association analysis of its member groups underscores the trend for growing hospital ownership of practices with physician employment.

The American Hospital Association tracks the number of physicians/dentists on the hospital payroll as part of its AHA Annual Survey. Annual trend data is reported in AHA Hospital Statistics, available for sale.

See update at https://aharesourcecenter.wordpress.com/2013/09/18/new-ama-data-on-physician-practices-and-physician-employment

Sources:

Kane CK. Policy research perspectives. The practice arrangements of patient care physicians, 2007-2008: an analysis by age cohort and gender. American Medical Association, Dec. 2009. http://www.ama-assn.org/ama1/pub/upload/mm/363/prp-200906-phys-prac-arrange.pdf

Clinical transformation: dramatic changes as physician employment grows. Accenture, Mar. 28, 2011. http://www.accenture.com/us-en/Pages/insight-clinical-transformation-physician-employment-grows.aspx

The state of medical practice: hospital ownership increases among MGMA practices – presence and price of hospital groups growing. MGMA Connexion, Jan. 2011. http://www.mgmaconnexion.com/connexion/201101/?pg=34#pg34

AHA Hospital Statistics.  Health Forum, an American Hospital Association subsidiary, 2010 [annual]. http://www.ahadata.com/ahadata/html/AHAStatistics.html

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org