How Many Physicians Are Independent in 2026?

The American Medical Association's 2024 Physician Practice Benchmark Survey, which polled 5,000 U.S. physicians and was published June 24, 2025, found that 42.2% of physicians were in private practice, meaning a practice wholly owned by physicians. That is down 17.9 percentage points from 60.1% in 2012. A separate report from the Physicians Advocacy Institute and Avalere, covering 2018 through 2026, counted 82% of physicians as employed by a hospital, health system, or corporate entity by the end of 2025, leaving 18% in physician-owned settings as of January 1, 2026.

Those two figures do not describe the same thing, and the gap between them is itself useful for a practice administrator trying to read the trend correctly. The AMA number comes from asking physicians directly about their own practice's ownership. The PAI-Avalere number comes from tracking employment and acquisition records across the health system, health plan, and private equity segments. Both point the same direction. Independent, physician-owned practice is shrinking, and it has been shrinking for over a decade.

What changed between 2012 and 2024

The AMA survey breaks out ownership by category for both years. Hospital-owned practices rose from 23.4% of physicians in 2012 to 34.5% in 2024. Physicians directly employed by or contracted with a hospital rose from 5.6% to 12.2% over the same period. Private equity ownership, tracked since 2022, rose from 4.5% of physicians that year to 6.5% in 2024.

Practice size shifted alongside ownership. In 2012, 61.4% of physicians worked in practices of 10 or fewer physicians. By 2024 that share had fallen to 47.4%, the first time it has dropped below half in the survey's history. Practices of 50 or more physicians grew from 12.2% of physicians in 2012 to 18.3% in 2024. Single-specialty practices fell from 45.4% to 37.2% of physicians, while multispecialty practices grew by roughly 6 percentage points over the same period, to 27.8%.

Ownership or size category	2012	2024
Private (physician-owned) practice	60.1%	42.2%
Hospital-owned practice	23.4%	34.5%
Directly employed by or contracted with a hospital	5.6%	12.2%
Private equity-owned practice	4.5% (2022)	6.5%
Practices of 10 or fewer physicians	61.4%	47.4%
Practices of 50 or more physicians	12.2%	18.3%

Source: American Medical Association, 2024 Physician Practice Benchmark Survey, published June 24, 2025.

Why physicians say they sell

The same AMA survey asked physicians who had sold a practice, or whose practice had been acquired, what mattered in that decision. Better ability to negotiate payment rates ranked highest, with 70.8% calling it very important or important. Improved access to costly resources, such as capital equipment or specialized staff, followed at 64.9%. Managing regulatory and administrative requirements came in at 63.6%. The AMA survey also notes that Medicare physician payment fell 33% in inflation-adjusted terms between 2001 and 2025, a backdrop that helps explain why payment terms top the list.

Independence still varies sharply by specialty. Ophthalmology had the highest private-practice rate among specialties tracked in 2024, at 70.4%, followed by orthopaedic surgery at 54% and other surgical specialties at 51.2%. Radiology stood at 46.9% and anesthesiology at 46.4%. Primary care specialties, including pediatrics, internal medicine, and family medicine, clustered in the high 30% to low 40% range, below the physician-wide average.

The 2026 employment count

The Physicians Advocacy Institute and Avalere report tracks a different measure: how many practices and physicians moved into hospital or corporate ownership. It found that hospitals and corporate entities acquired 13,900 additional physician practices between 2024 and 2025, bringing the corporate and hospital-owned share to 64% of all U.S. practices by the end of 2025. Hospitals accounted for 5,800 of those acquisitions, a 7.8% increase, while corporate entities such as insurers and private equity firms accounted for 8,000, a 10.2% increase.

On the employment side, the same report counted 48,000 physicians newly employed by hospitals or corporate entities in that two-year window. Hospitals added 44,000 of those physicians, an 8.2% increase in hospital payrolls, while corporate entities added 4,200, a 0.9% increase. Rural markets saw 1,200 practices acquired and 2,900 physicians move into hospital or corporate employment over the same period.

Private equity's role, and a recent reversal

A 2025 Government Accountability Office report, GAO-25-107450, put private equity ownership at 6.5% of physicians in 2024, up from 4.5% in 2022, matching the AMA figure. The GAO also found that private equity accounted for 65% of all physician practices acquired by any type of buyer between 2019 and 2023, a disproportionate share given how small its overall footprint remains. That share is highly specialty-dependent: in 2022, only 1.5% of primary care physicians worked in a private equity-backed practice, compared with 29% of retina specialists.

That pace has since slowed. STAT News reported on August 17, 2026, that private equity physician-practice-management deals are on track for roughly half the volume seen in 2025. Deal activity peaked at 851 transactions in 2021, according to PitchBook data cited in the report, and fell to just 105 in the first half of 2026. The article attributes part of the slowdown to more than a dozen states that have passed laws expanding oversight of private equity transactions in health care.

What this means for an independent practice

A practice weighing its own future is operating in a market where two different counts, one from physician self-reports and one from acquisition tracking, agree that independent ownership has fallen for over a decade, disagree on the exact remaining share, and now show private equity deal volume pulling back sharply in 2026 after years of growth. The specialty-level spread in the AMA data, from 70.4% private practice in ophthalmology down to the high 30% range in primary care, means a national average tells an individual practice very little about its own competitive position. The more useful comparison is against a practice's own specialty and region, not against a single blended number.

Sources

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