AMA: Independent practice not dead

While hospital employment of physicians is indeed on the rise, a new survey from the American Medical Association that more precisely breaks down physician practice arrangements shows that private practices do continue to thrive.

"To paraphrase Mark Twain, the reports of the death of private practice medicine have been greatly exaggerated," said AMA President Ardis Dee Hoven, M.D, in a statement. "This new data shows that while there has been an increase in hospital employment, more than half of physicians (53.2 percent) were self-employed in 2012, and 60 percent worked in practices wholly owned by physicians. Needed innovation in payment and delivery reform must recognize the wide range of practice types and sizes that exist today so all physicians can participate in the move to a more patient-centered system that rewards high-quality care and reduces costs."

The difference between the AMA's new Policy Research Perspectives, released Tuesday, and prior surveys is that with this instrument, even physicians who said they worked for a hospital were asked if they were employed directly by a hospital or by a practice owned by a hospital. The survey also asked physicians if the higher level ownership of their practice was wholly owned by practice physicians, wholly owned by an HMO/MCO, jointly owned by practice physicians and a hospital/hospital system, or wholly owned by a not-for-profit foundation, according to the report. The new structure allowed researchers, for the first time, to differentiate between physicians directly employed by a hospital and those working (as an owner or employee) in a practice owned by a hospital.

Other key findings of the new research include the following:

  • Only 23 percent of surveyed physicians worked in practices that were at least partly owned by a hospital in 2012, and another 5.6 percent were directly employed by a hospital.
  • The percentage of physicians who were practice owners in 2012 decreased 8 percentage points from 2007-2008.
  • Eighteen percent of physicians were in solo practice, down 6 percentage points from the 2007-2008 research.
  • Single-specialty practice was the most common practice type in 2012, accounting for 45.5 percent of physicians.

To learn more:
- here's the statement from the AMA
- read the study