In 1897, a reporter received a letter from an American writer in London with a now-famous line: “The report of my death,” Mark Twain wrote, “was an exaggeration.” Today, small, physician-owned practices could say the same, about a somewhat different report.
This report comes from the American Medical Association’s Physician Practice Benchmark Survey, a nationally representative survey of post-residency physicians. This year’s survey covered 3,500 physicians — each of whom must provide at least 20 hours of patient care per week, not be employed by the federal government, and practice in one of the 50 states or the District of Columbia. The surveys have been conducted in 2012, 2014 and 2016 — so we have three years of comparable data.
But the benchmark survey shows something else – the majority of physicians today still work in small practices.
At a surface level, some of these numbers were less than encouraging. The percentage of physicians who own their own practice has been on the decline. In 2012, 53.2% of physicians owned their own practice. In 2016, 47.1% did. To some, crossing that threshold of 50% was a signal that the anti-competitive trends in our healthcare system have pushed physician ownership to the side.
I don’t intend to claim there aren’t real concerns around competition. Recently, I’ve joined Carnegie-Mellon’s Martin Gaynor and Paul Ginsburg from the Brookings Institution in writing about the need for a new competition policy in healthcare. Americans today are paying the price for steady consolidation in the hospital and health insurance markets.
But the benchmark survey shows something else. If you dig into the data, you’ll see that the increase in hospital ownership has flatlined, the majority of physicians today still work in small practices and physicians are most likely working for other physicians…