- For the first time, physicians who have an ownership stake in their practice are in the minority in the U.S., the American Medical Association reports.
- The share of practice owners dropped to 47.1% in 2016, down from 53.2% in 2012, according to an updated AMA study on physician practice arrangements. During the same period, the share of physicians who worked for an employer increased from 41.8% to 47.1%.
- Helping drive the shift were younger physicians, two-thirds of whom opted for employment over ownership in 2016.
The milestone isn't surprising, as the trend of doctors working for hospitals has been strong for the past several years. Employing doctors can be expensive for hospitals after bonuses and insurance expenses are considered, but doctors often bring their patients with them. The shift also has financial impacts, as Medicare spends far less on treatments in physician-owned practices.
But those practices are facing a host of regulatory and administrative burdens related to the Affordable Care Act and MACRA, many of which favor consolidations and acquisitions. Studies have shown that physicians spend roughly half of their time on EHR and administrative tasks and just a quarter of their time actually seeing patients.
To address burnout, more physicians are seeking employment in organizations with the resources and IT infrastructure to handle increased documentation and reporting demands.
A September 2016 analysis by Alavere Health and the Physicians Advocacy Institute found that the share of physicians employed by hospitals or health systems shot up 86% from 2012 to 2015 — from 95,000 to more than 140,000.
Other findings from the AMA study:
- Surgical subspecialties had the highest share of owners at 59.3%, followed by radiology at 56.3%. The specialty with the lowest share of owners was emergency medicine (27.9%).
- While more than half of physicians (55.8%) worked in practices that were wholly physician-owned last year, that share had shrunk from 60.1% in 2012.
- Movement toward hospital-owned practices has slowed in recent years and held steady at 32.8% from 2014 through 2016.
- The percentage of physicians working in a practice with at least some hospital ownership or who are direct hospital employees was the same in 2014 and 2016 — 32.8 percent
- The majority of physicians (57.8%) still care for patients in practices with 10 or fewer doctors. Only 13.8% of doctors were in practices with 50 or more physicians in 2016, up slightly from 12.2% in 2012.