Physician employment patterns continue to shift away from independent practice, according to new data released by the American Medical Association.
The latest report shows a steady decline in physician-owned practices, which now represent just 42.2% of the workforce, down from 60.1% in 2012.
The AMA attributes the shift to persistent financial and administrative challenges that have made it increasingly difficult for physicians to remain independent. In a statement accompanying the report, AMA president Dr. Bruce A. Scott said, “The cumulative impact of burdensome regulations, rising financial strain, and relentless cuts in payment poses a dire threat to the sustainability of private practices.”
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The report highlights several factors driving the transition. Among physicians who sold their practices in the past decade, 70.8% cited inadequate payment rates as a key reason. Additional concerns included the need for access to high-cost resources (64.9%) and increasing payer-related administrative demands (63.6%).
Hospital-owned practices have absorbed much of this shift. In 2024, 34.5% of physicians worked in practices owned by hospitals—up 11 percentage points since 2012. Direct employment by hospitals also doubled over the same period, from 5.6% to 12%.
While still a minority, private equity ownership is also on the rise. In 2024, 6.5% of physicians reported working in private equity-owned practices, up from about 4.5% in both 2020 and 2022.
Specialty trends varied. Physician-owned practices remain more common in ophthalmology (70.4%), orthopedic surgery (54%), and surgical subspecialties (51.2%), but now represent a minority in cardiology (30.7%) and radiology (46.9%).
The analysis is part of the AMA’s ongoing Policy Research Perspective series, which tracks structural changes in physician practice models over time. Full reports are available on the organization’s website.