Practice Patterns: Young Oncologists Seek Benefits of Larger Practices, Hospitalist Jobs

Victoria Stern, MA

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December 17, 2014

In This Article

Striking Increase in Hospital Employment

Several recent analyses have mapped this shift in oncology practice patterns. A 2012 report from the American Hospital Association showed a movement toward hospital jobs, revealing a 32% increase in the number of physicians employed by community hospitals between 2000 and 2010.[1]

A 2014 study conducted by Merritt Hawkins also uncovered a striking increase in hospital employment.[2] The firm, which tracked the recruiting assignments of 3158 physicians and advanced practitioners, including physician assistants and nurse practitioners, from April 1, 2013 to March 31, 2014, found that 64% of searches were for hospital jobs. This represents notable increases from 56% in 2011 and 11% in 2004.[3]

Additionally, in 2014, only 1% of search assignments were for solo practice, compared with 20% in 2004.

Young oncologists seeking hospitalist jobs may also be on the rise. A report from the Society of Hospital Medicine found that the number of hospitalists in the United States increased from about 11,000 in 2003 to 35,000 in 2012.

Still, a 2012 American Medical Association (AMA) survey[4] noted that the shift to hospital employment may not be as drastic as other data have indicated.

According to the survey, of 3466 respondents, 53.2% reported being self-employed and 60% reported working in a practice wholly owned by physicians. Twenty-three percent worked in practices owned, at least in part, by a hospital, and only 5.6% were employed by a hospital directly.

The AMA survey, however, did find an overall movement toward hospital employment. In 1983, more than 75% of physicians were full or part owners of their practice, but by 2012 that percentage had dropped to about 50%. In 2012, almost 30% of physicians worked for a hospital or a practice affiliated with a hospital, an increase from 16.3% in 2008. In that time, the number of practice owners decreased by 8%. Although the AMA study did not focus on oncology per se, the employment trends for internal medicine subspecialties appeared to mimic the general trends observed for physicians.

"Overall, the data do indicate that oncologists are shifting from private, independent practices to hospital-based jobs," said Hagop Kantarjian, MD, chair of and a professor in the department of leukemia at the University of Texas MD Anderson Cancer Center in Houston. "A big factor in this movement is the change in profit margin, which has decreased in private practice but has increased for many hospitals that purchase oncology practices."

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