For the first time, according to data published by the American Medical Association (AMA), most physicians work outside of physician-owned practices. Using 2020 data from its Physician Practice Benchmark Surveys, the AMA describes how physicians’ practice arrangements have changed since 2012, finding that more doctors continue to gravitate away from private practice and toward employment by hospitals and other organizations.

The AMA surveys for information about physicians who are not employed by the federal government, who provide at least 20 hours of patient care per week and practice in one of the 50 states or the District of Columbia.

The survey gathered information on five aspects of physician practice arrangements, including the physicians' employment status, their practice type, practice size, and the ownership and business structure of their main practice. Physicians were asked to self-identify whether they are owners, employees, or independent contractors in their main practice. 

The AMA found that women physicians and younger physicians are more likely than male physicians and older physicians to be employed, 56.5 percent of women physicians employed compared to 46.7 percent of men. Forty-two percent of physicians age 55 and older were employed compared to 51.2 percent of physicians age 40-54 and 70.0 percent of physicians under the age of 40.

Emergency medicine was the only specialty in which more than 20 percent of physicians worked directly for hospitals, according to the survey. That share ranged from 5 percent and 13 percent in all other specialties except family medicine, where only 1.6 percent of physicians worked directly for hospitals.

Fewer than 40 percent of surgical subspecialists and radiologists were employed compared with 58 percent of pediatricians and family medicine physicians.