Traditionally a hallmark of success for many physicians, physician ownership of medical practices continues to decline, for now, according to a recent study by the American Medical Association (AMA). The AMA recently issued the results of a survey, entitled Policy Research Perspectives, Updated Data on Physician Practice Arrangements: Physician Ownership Drops Below 50%.
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The survey evaluated, among other things, whether physicians fall into one of four categories as to a physician’s “main” practice: (1) whether the physician is an owner, employee, or independent contractor of the medical practice; (2) the type of medical practice; (3) ownership structure of the practice; and (4) how many physicians are in the practice. The information and data reviewed spanned the period from 2012 to 2016. The survey results confirm a continued trend favoring employment and larger practices. 2016 was the first year with survey results demonstrating that less than half of practicing doctors (about 47%) own their own practice. Surveying over 30,000 physicians, the survey excluded physicians who work less than 20 hours/week providing patient care or are Federal employees.
The survey demonstrated the predictable direct correlation between age and likelihood of physician employment versus ownership: younger doctors were less likely to have an ownership interest in a medical practice: about 30% of physicians under age 40 were owners and about 55% of physicians age 55 and older were owners. Women, who have generally tended to enter medicine during a time where employment is more likely than owning and who tend to accept jobs in specialties where employment is more likely, have tended to work as employees rather than owners. Surgical sub-specialties (about 60%) and radiology (about 56%) had the greatest likelihood of physician ownership.
Most physicians still work in smaller medical practices, i.e., practices with 10 or fewer doctors. About 58% of all physicians work in such small practices, according to the survey. On the other hand, medical practice sizes are increasing as are the number of physicians who work in larger practices: about 14% of all physicians worked in 2016 in medical practices with 50 or more physicians, up about 2% from 2012. A majority of physicians also worked for physician-owned medical practices (about 56%), as opposed to other ownership structures, such as hospital owned medical practices.
Other studies have demonstrated a trend for physician practices to change from physician-owned to hospital-owned structures. For example, in an article appearing in AJMC.com, the authors evaluate the trend toward hospital ownership of medical practices and the impact of such upon the quality of care, specifically the use of care management processes and health information technology. According to a 2016 article in Modern Medicine Network, the number of medical practices owned by hospitals increased by almost 90% over the preceding four years. That same article indicates that nearly 40% of physicians were employed by hospitals and about 25% of all medical practices were owned by hospitals.
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