While physician leaders warily eye the decline of physician-owned practices, a new report published May 13 in the Journal of the Society of Laparoscopic and Robotic Surgeons suggests the private practice model still dominates physician employment — though shifts in the landscape are evident.
“Despite this perception, a gap in recent academic research comprehensively characterizes the trends in physician employment,” the report said. “There remains to be significant contradictions and a lack of cohesiveness in the available data from private sources.”
Analyzing data from over 213,000 medical practices from the U.S. Census Bureau and the Bureau of Labor Statistics, the report challenges the popular narrative of a dying private practice model. It also notes how inconsistencies in data, particularly regarding ownership, complicate the full picture of who actually owns and controls these practices.
According to the report, while consolidation is occurring and hospital employment is rising faster, private practice remains the most common setting for U.S. physicians.
Here are eight things to know:
1. As of 2022, 55% of physicians in the U.S. worked in private practices. This is down just 3 percentage points from 2013 (58%), suggesting only a modest decline over the past decade.
2. The number of hospital-employed physicians rose 33% between 2013 and 2022 — from around 157,000 to over 205,000. In contrast, private practices grew by 17%, indicating hospitals are hiring at roughly double the rate.
3. The total number of employed physicians increased 22% over the last decade — from roughly 620,000 in 2013 to over 760,000 in 2022.
4. Of the 213,000 medical practices in 2020, 73% were small (fewer than 50 employees). However, the number of small practices declined by 16% over the past 20 years, while large practices saw steady growth.
5. Only 3% of physicians work in academic institutions, a number that remained unchanged from 2013 to 2022. Government-employed physicians accounted for 12% in 2022, down 2 percentage points from a decade earlier.
6. In 2020, there were over 224,000 physician offices nationwide. California had the highest number of offices at 2,954, while New Jersey led in office density at 2.3 per 1,000 households. North Dakota had the fewest offices both in total and by household density.
7. From 2007 to 2020, 31 states saw a net decline in physician offices, with New York alone accounting for 26% of the nationwide losses. Other significant declines occurred in Ohio, Illinois, Massachusetts and Pennsylvania.
8. One key limitation the report points to is the lack of publicly available data on whether private practices are physician-owned. Most ownership data come from proprietary sources, making it difficult to determine how many physicians are truly in control of their workplaces.
