AMA says the physician exodus to hospitals overrated

Recent reports claiming that physicians are moving swiftly away from private practices into hospital employment are exaggerated, according to a report released by the American Medical Association (AMA).

In its 2012 Physician Practice Benchmark Survey, the AMA reports that 60% of physicians work in physician-owned practices, and about 53% were self-employed. Conversely, only 23% work for practices partially owned by hospitals and nearly 6% worked solely for a hospital.

These numbers seem opposite of media reports of shrinking private practices and solo practitioners being swallowed by large hospital groups. For example, the Medical Group Management Association (MGMA) reported in its Physician Compensation and Production Surveys that almost half of physicians worked for hospital-owned practices in 2011. AMA says that the MGMA’s membership of predominately large practice groups skews the numbers.

The AMA also debunks the American Hospital Association’s (AHA) data that states physicians employed by community hospitals increased from 160,000 in 2000 to 212,000 in 2012, a 32% increase. A recent Accenture reported states that though 57% of physicians worked at an independent practice in 2000, that number would dwindle to 36% this year.

New payment and healthcare models that focus on collaborative and team-based care are blamed for the assumption that physicians would flee to hospitals, says AMA. “While these shifts in practice have been reported in certain locations, whether they are a part of a national trend is unknown because of lack of recent, nationally representative data on physicians,” the authors of the AMA study states.

According to AMA another flaw in studies about physician practice ownerships lies in leaving out specialists. The study finds that surgeons, anesthesiologists, radiologists and gynecologists report ownership of more that 50% of practices in their respective fields. Ownership numbers are lower in areas of pediatrics (37.3%), emergency medicine (38.4%), and family practices (39.8%).

“Researchers looking at single specialty groups in the late 1990s and early 2000s were struck by the almost complete absence of research into the organization of specialty practice,” states the AMA.