For the first time, less than 50 percent of physicians reported working in physician-owned practices last year, according to a May 5 American Medical Association report.
The AMA surveyed 3,500 physicians in September and October 2020 about their employment and practice situations.
Five findings:
1. Forty-nine percent of physicians worked in wholly physician-owned practices last year, including 38.4 percent who are practice owners.
2. Since 2018, the number of physicians in private practice dropped 5 percentage points.
3. Sixty-six percent of surgical specialists are in private practice.
4. One-third of physicians younger than 40 were in private practice.
5. Forty-three percent of physicians worked in single-specialty practices, and 26.2 percent worked in multispecialty groups.
Few physicians attributed changing employment status to the pandemic, indicating a larger trend away from physician ownership, the report said. ASC leaders in markets across the U.S. face challenges finding new physicians for their centers as independence wanes.
Brian Bizub, CEO of Raleigh Orthopaedic, said that while communities in North Carolina are growing rapidly, there has been a shift away from private practice to hospital employment. He said reimbursement declines in private practice make it difficult to manage overhead, and the referral networks are drying up as primary care physicians become affiliated with hospitals.
"The current state of healthcare reform is creating uncertainties, and the shift in physician preferences are leaning toward hospital employment over private practice," he said. "Recent trends and published studies clearly show that younger physicians are interested not only in practicing medicine, but maintaining a quality home life as well. Less interest exists in physicians seeking administrative tasks and concerns with overhead and payer reimbursements."
His group has been able to maintain private ownership because of collaboration with a local health system to become part of its referral network.
On the other hand, some communities are seeing a spike in the number of physicians interested in ASCs. Danilo D'Aprile, administrator of Danbury, Conn.-based Orthopaedic Specialty Surgery Center, said more physicians have requested center credentials since the pandemic began, especially for total joint replacements.
"Our total joint replacement program is very robust," he said. "We are in a good position to attract a lot of these doctors, and I have a lot of physicians coming to me to request privileges and ownership because they want to be here."