Percentage of radiologists in private practice continues to plummet, AMA says

The number of radiologists working in private practice continues to plummet, according to new data from the American Medical Association released Thursday. 

About 46.9% of physicians in the specialty said they work in a setting wholly owned by physicians rather than a hospital, health system or other entity as of last year. That’s down from 49.7% of radiologists in AMA’s previous every-other-year benchmark survey released in 2023 and 63.6% in the inaugural 2012 edition.

Overall, about 42.2% of all physicians surveyed said they work in private practice, down 18 percentage points from the initial figure of 60.1% 13 years ago. This figure would mean about 80,000 fewer physicians were in private practice last year than 2012. Private practice now accounts for less than half of most specialties, AMA noted, ranging from 30.7% for cardiology up to radiology’s nearly 47%. Surgical subspecialties (51.2%), orthopedics (54%) and ophthalmology (70.4%) were the three exceptions. 

Potential reasons for this shift include “inadequate payment rates,” the high cost of resources, and “burdensome” regulatory and administrative requirements, the AMA said. 

“The share of doctors working in practices wholly owned by physicians is unraveling under compounding pressures,” AMA President Bruce A. Scott, MD, said in a statement May 29. “The cumulative impact of burdensome regulations, rising financial strain, and relentless cuts in payment poses a dire threat to the sustainability of private practices.”

This latest Physician Practice Benchmark Survey utilized a nationally representative sample of U.S. physicians who have completed residency, provide patient care at least 20 hours per week and are not employed by the government. AMA used WebMD/Medscape to conduct the survey for the first time, allowing for an expanded panel of 5,000 physicians (M3 Global Research managed the previous surveys with a sample of 3,500). 

On the other side, the share of physicians working in hospital-owned practices increased to 34.5%, up 11 percentage points from the initial survey (23.4%). About 12% of physicians were employed or contracted directly with a hospital, up from 5.6% in 2012. Another 6.5% said their practice is owned by private equity, up from 4.5% in the 2020 and 2022 surveys. When independent physicians were asked why they sold their practice to a private equity firm, hospital or insurer over the last 10 years, “inadequate payment rates” was the No. 1 answer, cited as “important” or “very important” by 70.8% of respondents. Other common reasons included improving access to resources (64.9%), better managing payer requirements (63.6%), and easing participation in risk-based payment models (55.1%). 

Previous studies have calculated a different share of physicians in private practice, AMA noted, but also “clearly find the same directional trend.” Last year, the Physician Advocacy Institute estimated that the number of docs in “independent practice” fell from 37.8% in 2019 down to 22.4% five years later. At the same time, the share of those working for hospitals, private equity firms and other “corporate entities” increased from 62.2% up to 77.6%. 

“Importantly, that analysis focuses on the ownership of physicians’ affiliated practices, which are not necessarily the practices in which they are employed or have an ownership stake,” the AMA report noted. “Although practice ownership can be complex when hospitals, private equity groups, and insurers are involved, we believe that when surveyed, physicians are able to accurately report whether they are in practices that are wholly owned by physicians (private practice).”

Another recent study, published in the Journal of the Society of Laparoscopic & Robotic Surgeons, estimated that hospital employment has risen 33% during the decade ending in 2022 while private practice employment was up 17%. This analysis—based on U.S. Census and Bureau of Labor Statistics data—also estimated that about 55% of physicians work in private practices, down 3% from a decade ago, while 27% are hospital employed, up 25%.