Fewer than half of US physicians now work in a small practice. The American Medical Association's 2024 Physician Practice Benchmark Survey of 5,000 physicians found that 47.4% worked in practices of 10 or fewer physicians, down from 61.4% in 2012.
The share working in practices of 50 or more physicians rose from 12.2% to 18.3% over the same period. The AMA fielded the survey from late August through September 2024 and reported a 43% response rate.
How the AMA measures practice size
The AMA has run the survey every two years since 2012. The 2024 wave raised the sample from 3,500 to 5,000 physicians and moved to the WebMD/Medscape panel, which held about 55,000 eligible physicians. NORC at the University of Chicago built the survey weights. A physician qualifies after finishing residency, seeing patients at least 20 hours a week, and working outside the federal government.
Physicians count every site and every physician in their practice, so the measure is firm size, not office size. Physicians who work directly for a hospital sit in a separate row. They made up 13.0% of the 4,674 physicians who answered the size question. The AMA left out physicians who did not know their practice size.
Practice size in 2012, 2020 and 2024
The smallest practices lost the most ground. Practices with fewer than five physicians employed 40.0% of physicians in 2012 and 28.8% in 2024, a fall of 11.2 percentage points. The 5 to 10 band slipped from 21.4% to 18.7%. The AMA notes that around 80% of physicians worked in practices of 10 or fewer in the early 1980s.
| Practice size | 2012 | 2020 | 2024 |
|---|---|---|---|
| Fewer than 5 physicians | 40.0% | 33.6% | 28.8% |
| 5 to 10 physicians | 21.4% | 20.0% | 18.7% |
| 11 to 24 physicians | 13.4% | 11.5% | 12.5% |
| 25 to 49 physicians | 7.1% | 7.8% | 8.8% |
| 50 or more physicians | 12.2% | 17.2% | 18.3% |
| Direct hospital employee or contractor | 5.8% | 9.7% | 13.0% |
Source: AMA Policy Research Perspectives 2025-3, Exhibit 5. Share of physicians; N was 3,326 in 2012 and 4,674 in 2024.
The middle bands barely moved. Practices of 11 to 24 physicians held 12.5% in 2024 against 13.4% in 2012. Practices of 25 to 49 physicians gained 1.7 points.
Solo, single specialty and multispecialty groups
Solo practice fell from 18.4% of physicians in 2012 to 11.9% in 2024. Single specialty groups fell from 45.4% to 37.2%, though they still employ more physicians than any other practice type. Multispecialty groups rose from 22.1% to 27.8%.
The two group types differ sharply in size. Among physicians in single specialty groups, 62.8% work in practices of 10 or fewer and 10.5% in practices of 50 or more. Among physicians in multispecialty groups, 29.0% work in practices of 10 or fewer and 40.6% in practices of 50 or more.
Employment status shifted too. In 2024, 57.5% of physicians were employees, up from 41.8% in 2012. Owners fell from 53.2% to 35.4%, and 7.1% were independent contractors. The shift in employee and owner shares since 2022 was about eight percentage points each way, larger than any earlier two-year change.
Ownership and size travel together
Physician-owned practices are small. The AMA found that 42.2% of physicians were in private practice in 2024, against 60.1% in 2012. Hospital-owned practices covered 34.5%, up from 23.4%. Another 12.2% worked directly for a hospital, and 6.5% were in practices owned by private equity groups.
| Practice size | Physician-owned | Hospital-owned | Private equity-owned |
|---|---|---|---|
| Fewer than 5 physicians | 49.2% | 16.1% | 12.9% |
| 5 to 10 physicians | 19.7% | 23.0% | 21.9% |
| 11 to 24 physicians | 11.6% | 16.4% | 20.9% |
| 25 to 49 physicians | 7.8% | 13.3% | 11.7% |
| 50 or more physicians | 11.8% | 31.3% | 32.6% |
Source: AMA Policy Research Perspectives 2025-3, Exhibit 7, 2024 survey. Sample sizes were 2,149 physician-owned, 1,461 hospital-owned and 284 private equity-owned.
Almost half of physicians in private practice, 49.2%, work in a practice with fewer than five physicians. The AMA cautions that physicians in larger owned organizations may report only part of the organization, so their size shares could run low.
The AMA estimates that about 80,000 fewer physicians were in private practice in 2024 than in 2012. It bases that on 650,750 eligible physicians in 2012 and 737,195 in 2024.
Why physicians say practices were sold
The AMA asked 520 physicians whose practices were acquired after 2014 to rate six reasons for the sale. Better payment rate negotiation scored "important" or "very important" with 70.8%. Access to costly resources scored 64.9%. Managing regulatory and administrative requirements scored 63.6%, and easing participation in risk-based payment models scored 55.1%. Adding services and competing for employees each landed just under 50%.
The same three reasons ranked highest for practices sold before 2020 and after. Among 2,027 physicians in practices owned by hospitals, private equity groups or insurers, 15.1% said the sale happened after 2019, 15.3% between 2015 and 2019, and 41.6% before 2015. Another 28.0% did not know. Among physicians in private equity-owned practices, 38.3% reported a sale after 2019, compared with 10.0% in hospital-owned practices.
Using the size bands to benchmark
A practice with seven physicians sits in the band that held 18.7% of physicians in 2024. A practice with 60 physicians sits in the band that held 18.3%. Peer comparisons for denial rates, staffing ratios or days in A/R work best inside one band, since a group of 60 and a group of 7 run different front-desk and billing structures.
Ownership stake follows size. Only 35.4% of physicians held an ownership stake in 2024, against 53.2% in 2012, and around 76% in the early 1980s. The AMA reports that the Physicians Advocacy Institute counted 22.4% of physicians in independent practice in 2024, down from 37.8% in 2019, using a different method based on practice affiliations.
Sources
- American Medical Association, Physician Practice Characteristics in 2024: Private Practices Account for Less Than Half of Physicians in Most Specialties (Policy Research Perspectives 2025-3), May 2025
- American Medical Association, Smaller share of doctors in private practice than ever before, June 24, 2025
- American Medical Association, Physician Practice Benchmark Survey, 2024 edition page
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