PAI Research

Physicians Advocacy Institute

Physician Employment Trends

PAI-Avalere Report on Physician Employment and Practice Ownership Trends:  Specialty Edition 2019-2021

This Specialty Edition report, released in June 2022, continues PAI’s longstanding research collaboration with Avalere Health to collect information relating the ongoing trend of increasing physician employment by hospitals and other corporate entities, spurred in part by acquisitions of physician practices. This report adds to the national physician employment trends study that PAI and Avalere released in April 2022 showing a steady trend towards employment and medical practice acquisitions that sharply increased in the period following the start of the pandemic. 

In this specialty edition of the report, Avalere Health researchers examine two related consolidation trends for physician employment and practice ownership (by hospital/health systems and other corporate entities) across physician specialties/subspecialties and specialty groupings.

Avalere examined these trends for 53 physician specialties, grouped into five mutually exclusive specialty categories:

  1. Primary Care Specialties
  2. Internal Medicine Subspecialties (“Medical”)
  3. Surgical Subspecialties
  4. Other Physician Specialties (“Other”)
  5. Pediatricians

Key findings

The report shows that the employment and practice acquisition trends for primary care specialties, surgical specialties and pediatricians track the trends for physicians overall, with minor variations. 

  • Internal medical subspecialties have higher than average employment and practice ownership than other categories. 
  • The category of “other” physician specialties, which include various specialties with varying characteristics, have lower employment and practice ownership percentages than the other categories or than the national average. 

Overall employment by Physician Specialty Category – January 1, 2022
Other Specialties – 63.8%
Primary Care specialties - 74.3%
Surgical Specialties – 74.8%
Pediatric Specialties – 74.9%
Medical Specialties – 82.4%

Overall Practice Ownership by hospitals/health systems and “other” corporate entities – January 1, 2022
Other Specialties – 54.4% ownership
Primary Care – 55% ownership
Surgical Specialties – 59.8% ownership
Pediatric Specialties – 61.8% ownership
Medical Specialties – 69% ownership

The appendices following the report include detailed practice trend information on each of the individual physician specialties.

Report PDF
Key Finds PDF