More than 60% of physicians work for small practices

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Although hospitals are increasingly purchasing physician practices, more than 60 percent of doctors still worked in practices of 10 or fewer physicians in 2014, according to an American Medical Association (AMA) survey released on July 8. However, younger physicians were more likely to work for hospitals.

The survey found that 60.7 percent of physicians in 2014 worked for practices of 10 or fewer doctors, a slight decrease from 61.4 percent two years earlier but a large decline from 79.6 percent in 1983.

Carol K. Kane, PhD, an AMA economist and the study’s author, noted that 43.8 percent of physicians in 1983 worked in solo practices compared with 18.6 percent in 2014. During that same time period, the proportion of physicians working in practices with 25 or more doctors increased from 5 percent to 19.8 percent.

The nationally representative survey included responses from 3,500 physicians who provided at least 20 hours of patient care per week and worked in the U.S. It was conducted in September and October 2014.

From 2012 to 2014, the proportion of doctors working for a hospital or in a practice partially owned by a hospital increased from 29 percent to 32.8 percent. A previous study found 16 percent of physicians worked for a hospital or in a practice at least partially owned by a hospital in 2007 and 2008, according to Kane.

In 2014, 50.8 percent of physicians owned their practices, down from 53.2 percent in 2012 and 76.1 percent in 1983. In addition, 43 percent of physicians were employed by their practices and 6.2 percent had a contract with their practice. Kane wrote that the percentage of contracted physicians has not changed much since the mid-1980s.

Among physicians who were 40 years old or younger, 59 percent worked for a practice and 12 percent were direct hospital employees compared with 33.3 percent and 4.8 percent of physicians who were older than 54, respectively.

Kane also found that 51.8 percent of women physicians and 38.8 percent of male physicians were employed by their practice. She added that female physicians are generally younger than males, which contributes to the increasing percentage working for practices.