Dive Brief:

• For the first time, employed physicians outnumber self-employed physicians, a study from the American Medical Association found. The report is based on survey data AMA collects every other year, beginning in 2012.
• Employed physicians — or those who work for a hospital, as an example — represented 47.4% of all patient care physicians in 2018, while independent physicians with an ownership stake were 45.9% of all patient care physicians
• The physician ownership of practices varied among specialties. Surgical subspecialties had the highest share of owners with 64.5%, obstetrics and gynecology practices followed with 53.8%. Emergency medicine had the lowest share of owners.

Dive Insight:

The findings represent a milestone in a continuing trend of declining physician ownership of medical practices. Despite the changing ownership dynamics, AMA's study found that most physicians still work in small practices.

"This share has fallen slowly but steadily since 2012. In 2018, 56.5% of physicians worked in practices with 10 or fewer physicians compared to 61.4% in 2012," the study found.

Smaller physician practices have attempted to weather healthcare reform and squeezes on reimbursement. Some have decided to sell their practices to insulate them from those headwinds, among others.

But it's not just hospital groups that are interested in buying physician practices. Private equity groups are increasingly interested in picking up physician groups, and experts say private equity investment in healthcare is poised to see another robust year.

Private equity investors are interested in areas that are highly fragmented and siloed. An area of interest likely to attract investment this year is orthopaedic groups, a previous report from the investment funds team at the law firm BakerHostetler found.

AMA said the survey was conducted in September, reaching 3,500 physicians, with a response rate of 36%.