The Physician Practice Benchmark Survey is a nationally representative survey conducted by the American Medical Association (AMA), targeting physicians who have completed residency, provide patient care, and practice in one of the fifty states or the District of Columbia. This survey specifically focuses on physicians who do not work for the federal government and who see patients for at least twenty hours per week. The survey collects information on various aspects of physician practices, including the type of main practice where the physician works, the ownership structure of that practice, the number of physicians involved, and whether physicians are owners, employees, or independent contractors within their main practice. First conducted in 2012, the survey is administered every other year. The 2024 survey data is analyzed alongside previous survey results to provide updated insights into ongoing trends in physician practice arrangements and payment methodologies.
The trends identified in this survey are highlighted in the AMA Policy Research Perspectives report by Carol K. Kane, PhD. Through which Kane reveals significant changes in the ownership and organization of physician practices since 2012. The report shows that physician practices are increasingly owned by hospitals or other organizations, with the proportion of wholly physician-owned private practices declining by 18% from 60.1% in 2012 to just 42.2% in 2024. Similarly, the percentage of physicians who hold an ownership stake in their practice dropped from 53.2% to 35.4% over the same period. Conversely, hospital-owned practices have grown substantially, with their share increasing from 23.4% in 2012 to 34.5% in 2024. The data also depict shifts in practice size: in 2024, 47% of physicians reported working in practices with 10 or fewer physicians, down from 61.4% in 2012 and approximately 80% in the 1980s. Lastly, there is a growing trend toward multi-specialty practices, with the gap between single-specialty and multi-specialty practices narrowing from 23% in 2012 to just 9% in 2024. However, single-specialty practices still have more physicians overall.
The report categorizes physician practice ownership into three types: private practices, hospital-owned practices, and private equity-owned practices. Private practices are distinguished by their smaller size and predominance of single-specialty practices, with nearly half of physicians in these settings working in groups of fewer than five doctors and approximately 68% practicing in single-specialty groups. In contrast, hospital-owned practices tend to be larger and more likely to be multi-specialty; over 30% of physicians in hospital-owned practices work in groups of 50 or more, while only 16.1% are in practices with fewer than five doctors. Additionally, 44.3% of physicians in hospital-owned practices work in multi-specialty settings, compared to 31.3% in single-specialty groups. Private equity-owned practices resemble hospital-owned practices in terms of size but are more similar to private practices regarding specialty composition, with about 63.4% of physicians in single-specialty groups and 27.7% in multi-specialty practices.
When viewed in aggregate with the prior benchmark surveys, the 2024 survey shows a continued decline in the number of physicians working in small, physician-owned practices. Instead, physicians are increasingly working in larger, more often multi-specialty practices, which are more likely to be owned by hospitals or private equity groups. This 18% drop in private physician-owned practice represents approximately 80,000 fewer private practice physicians in 2024 compared to 2012. This same directional trend has been corroborated by other studies as well. For example, the Physician Advocacy Institute found that the share of physicians in independent practice fell from 37.8% in 2019 to 22.4% in 2024. That study also found that physicians who are employees of hospitals or other corporate entities increased from 62.2 in 2019 to 77.6 in 2024.
In terms of underlying reasons for this trend, physicians’ responses to the survey indicate three key drivers for the shift towards non-physician-owned practices. Those three reasons are (1) the need to better negotiate higher payment rates with payers, (2) to improve access to costly resources, and (3) to better manage payers’ regulatory and administrative requirements. These findings are consistent with other research showing that markets featuring larger physician groups and increased physician-hospital integration tend to have higher prices for physician services.
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