Dan Choi: Physician Practice Characteristics in 2024
Dan Choi, Minimally Invasive Spinal Surgeon at Spine Medicine and Surgery of Long Island, posted on X:
“New AMA data confirms it: fewer than half of U.S. physicians are now in private practice.
Just 42.2% in 2024, down from 60.1% in 2012. Let’s unpack the trends, what’s driving the decline, and why it matters for physicians and patients.
The decline in private practice is accelerating:
Physician-owners:
2012: 53.2%
2024: 35.4%
Small practices (≤10 MDs):
2012: 61.4%
2024: 47.4%
Private practice is vanishing across almost all specialties.
So where are physicians going?
- Hospital-owned practices now account for 34.5%
- Private equity-owned practices hit 6.5% in 2024
- Direct hospital employment doubled since 2012 (12.2% in 2024)
It’s a shift from autonomy to employment.
What’s driving this trend?
Physicians in acquired practices say these 3 reasons are most important:
- Inability to negotiate higher payment rates
- Lack of access to expensive resources
- Burden of regulatory/admin requirements
The system is squeezing out independents.
Not all specialties are affected equally:
High private practice rates:
•Ophthalmology: 70%
•Ortho: 54%
•Surgical subspecialties: 51%
Low rates:
•Emergency Med: 33%
•Internal Med, Pediatrics, Family Med: 38–44%
Private equity is a newer disruptor.
- 38% of PE acquisitions happened after 2019
- In contrast, 47% of hospital acquisitions happened before 2015
This suggests a new wave of corporate consolidation is still gaining steam.
Practice size tells the story:
Private practice: 49% have <5 MDs
Hospital-owned: Only 16% have <5 MDs; 31% have ≥50 MDs
The era of the small, independent practice is fading fast.
Why does this matter?
- Less physician ownership = less clinical autonomy
- More consolidation = higher costs (per studies)
- Larger systems may prioritize margins over medicine
This shift isn’t just about business—it affects care delivery.
Bottom line: The U.S. is undergoing a profound shift in how healthcare is organized.
Private practice isn’t dead—but it’s on life support. Reversing the trend will require payment reform, regulatory relief, and support for physician autonomy.
Full AMA report here (May 2025): “Physician Practice Characteristics in 2024””
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