While the decline of independent practice has persisted as a general trend across medicine, the consolidation of physician practices has played out differently across specialties.
A 2025 specialty-level breakdown of independent practice published by the American Medical Association found private-practice rates ranging from 70.4% in ophthalmology down to 30.7% in gastroenterology, a nearly 40-percentage-point gap between the most and least independent of the five specialties driving the bulk of physician practice mergers and acquisitions activity.
Here’s where each of the five stands, ranked from most to least independent:
Ophthalmology
- 70.4% of ophthalmologists were in private practice as of 2024, the highest rate of the five specialties, per AMA data.
- Deal volume has cooled considerably: Fewer than 100 ophthalmology groups changed hands in 2025, compared with more than 300 in 2021, according to VMG Health.
- The largest transactions of 2025 still carried significant price tags: Conshohocken, Pa.-based Cencora acquired Retina Consultants of America, and Irving, Texas-based McKesson paid $850 million for an 80% stake in Prism Vision Holdings.
- Sector analysts expect fewer, larger deals to continue into 2026, as an aging population sustains long-term demand for eye care.
Orthopedics
- 54% of orthopedic surgeons were in private practice, the second-highest rate of the five specialties, AMA data show.
- Private equity has nonetheless built a dense platform network across the specialty, though the pace has slowed and drawn new scrutiny: Only 5 of 68 orthopedic transactions reviewed from 2010 to 2019 were private equity-backed, but PE-backed platforms launched 11 times between 2019 and 2021 alone.
Anesthesiology
- 46.4% of anesthesiologists were in private practice, per the AMA.
- The specialty has drawn some of the most scrutinized private equity activity in medicine. Anesthesiologists made up 33.1% of physicians employed by groups acquired by private equity firms between 2013 and 2016, and 19.4% of physician groups acquired by private equity firms were anesthesia groups, according to a February 2026 literature review in Anesthesiology.
- Dallas-based U.S. Anesthesia Partners, backed by New York City-based Welsh, Carson, Anderson & Stowe, has acquired more than a dozen anesthesiology practices in Texas since 2012. USAP paid $200,000 and agreed to divest from five Colorado hospitals in February 2024 to settle antitrust allegations, according to the Colorado Attorney General’s office.
Cardiology
- 31.7% of cardiologists were in private practice, tied closely with gastroenterology for the lowest rate of the five specialties, per AMA data.
- More than 340 private equity acquisitions of cardiology clinics have occurred since 2013, with more than 94% of them between 2021 and 2023, Becker’s ASC Review counted.
- Six practice acquisitions closed in the first half of 2025 alone, matching the total for all of 2024.
Gastroenterology
- 30.7% of gastroenterologists were in private practice, the lowest rate of the five specialties, per AMA data.
- Between 2013 and 2023, private equity firms acquired 114 outpatient gastroenterology practices encompassing 1,169 clinical sites, including 854 clinics, 266 endoscopy centers and 49 infusion centers, according to a January study in Clinical Gastroenterology and Hepatology.
- Roughly 14% of GI clinical sites nationwide are now private equity-affiliated, though practices in lower-income ZIP codes were about 60% less likely to be acquired than those in wealthier areas, the study found.
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