The number of private practice physicians in the U.S. is declining, but why? And what does this mean for the future of private practice as a whole?
According to a report from the American Medical Association, the number of physicians working in private practices decreased by 13 percent between 2012 and 2022. Many of these physicians are opting to join large health systems, private equity groups or employed settings. The number of physicians younger than 45 who were self-employed decreased by 13 percent between 2012 and 2022, according to the AMA report.
"Physicians remaining independent are going to be few and far between. They're either going to go with these large equity groups or hospitals or something like that," Sheldon Taub, MD, a gastroenterologist at Jupiter (Fla.) Medical Center told Becker's. "You still have a quote, unquote, 'private practice,' but you have guidelines and rules that you have to conform to so it meets their criteria. So right away, you feel a little bit of your autonomy being compromised, and then the bigger the group gets, the more restrictions they have on what you can do to stay in the group and conform to what they want you to do. On top of that, the government throws in their regulations too. The private practitioner is a dying breed."
Why are physicians leaving the world of private practice?
"With recent reimbursement changes from major medical insurances as well as cuts from CMS, it is very difficult to maintain revenue in private practice," Li Sun, DO, orthopedic and spine surgeon at Sun Orthopaedic & Spine Care in Metuchen, N.J., told Becker's. "I think fewer and fewer private practices will be able to survive on their own without being affiliated with healthcare systems or large [management service organizations]."
About 80 percent of physicians who own their practices said the ability to negotiate higher payment rates with insurance companies influenced their decision to sell their practice, according to the AMA report.
"Private practice will still be around, just different," Bhagwan Satiani, MD, professor of surgery emeritus in the department of surgery at the Ohio State University in Columbus, told Becker's. "Suspect practices left standing will be: large single-specialty or multispecialty groups or those owned by large national systems such as United Healthcare, Cigna, etc., or private equity. I guess you could call them private. Bottom line, there will be fewer 'self-employed.'"