Evidence-Based. Clearly Delivered.
Evidence-Based. Clearly Delivered.
Based on the most recent biennial survey data from the American Medical Association (AMA), released in May 2025 reflecting 2024 data, the long-term shift toward physician employment has solidified into a new standard for healthcare delivery. While 2018 marked a historical turning point where employed physicians slightly outnumbered practice owners for the first time, the gap has widened substantially since then. According to the AMA’s analysis, the share of physicians working in private practices (wholly owned by physicians) has dropped to 42.2%, an 18 percentage point decrease since 2012. Consequently, a clear majority of physicians, 57.5%, are now classified as employees, while only 35.4% have an ownership stake in their practice.
A breakdown of current demographics shows that while the overall trend is toward employment, significant variations exist across specialties. Surgical subspecialists still maintain higher rates of private practice ownership compared to primary care fields. Ophthalmology stands out as the specialty with the largest share of physicians in private practice (70.4%), followed by orthopedic surgery (54.0%). Fewer than half of physicians in primary care field, such as family medicine, internal medicine, and pediatric, remain in private practice, and among general surgeons, the share is even smaller, with less than one‑third still practicing independently.
The survey data indicates that the shift away from physician ownership is rapidly accelerating due to long-standing hurdles. Physicians cited the need to better negotiate payment rates with payers, the necessity of improving access to costly resources, and the increasing burden of managing regulatory and administrative requirements as the primary reasons for selling their private practices to larger entities.
This transition in ownership is fundamentally reshaping the structure of medical practice in the United States. The data highlights a significant decline in small, independent practices; for the first time, fewer than half of all physicians (47.4%) work in practices with 10 or fewer physicians. Private practices are now characteristically very small, while practices owned by health systems or corporate entities tend to be much larger and multi-specialty focused. Furthermore, while hospital ownership has grown steadily to include more than one-third of physicians, the market is seeing the rise of newer ownership models, with 6.5% of physicians now working in practices owned by private equity firm, a trend that has gained traction particularly since 2019.
Physicians Advocacy Institute” Employed Physician Survey
AMA: Understanding physician employment contracts
Things to consider before you choose a practice setting
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