June 5, 2025
Physicians continue to move away from private practices and increasingly work at practices owned by hospitals or private equity groups, according to the latest AMA analysis.
Physicians reported that the key factors driving this change include: inadequate payment rates, costly resources, and burdensome regulatory and administrative requirements.
“After adjusting for inflation in practice costs, Medicare physician payment has fallen 33 percent over the past quarter century, which has severely destabilized private practices and jeopardized patients’ access to care,” said AMA President Bruce A. Scott, MD. “Payment updates are necessary for physicians to continue to practice independently.”
According to the analysis, the share of physicians working in private practices in 2024 was 42.2%, a decline of 18 percentage points from 60.1% in 2012. Private practices now account for less than half of physicians in most medical specialties, ranging from 30.7% in cardiology to 46.9% in radiology. Exceptions included orthopedic surgery (54%), ophthalmology (70.4%), and other surgical subspecialties (51.2%).
In contrast, the share of physicians working in hospital-owned practices in 2024 increased to more than one-third (34.5%), an increase of 11 percentage points from 23.4% in 2012. Twelve percent of physicians were employed directly by a hospital (or contracted directly with a hospital), double the share (5.6%) in 2012.
In 2024, 6.5% of physicians characterized their practice as private equity-owned, higher than the shares in 2020 and 2022, which were both around 4.5%, the report noted.
Among independent physicians who sold their practices in the last 10 years to a hospital, private equity firm, or insurer, the most cited reason was inadequate payment rates (rated as important or very important by 70.8% of physicians). Next was the need to improve access to costly resources (64.9%) and better manage payers’ regulatory and administrative requirements” (63.6%).
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