One- and two-doctor practices may become a thing of the past as an increasing number of physicians are being wooed by hospitals.A recent article in the American Medical Association News magazine reports that solo practices may be becoming a thing of the past. According to a study by the Center for Studying Health System Change, during the period between 1996 and 2005, the percentage of one- and two-physician practices declined from about 41% to 32%, while single-specialty groups with 6 or more physicians increased from about 13% to 18%.

Joy H. Grossman, PhD, a co-author of the report, credits such issues as a better work-life balance and a perception of less hassle as a reason for new physicians preferring to join larger groups. Practices across the spectrum have seen decreasing salaries despite increased productivity, and solo practices are less able to absorb this financial impact.

Hospitals have had a sharp rise in the number of physicians they are recruiting, usually at the expense of these smaller groups. Another report discusses the increasing number of proceduralists (physicians who only perform procedures and do not have their own patients) being hired by hospitals.

So what does this mean for existing practices? Well, solo or small practices will find themselves competing with hospitals for the brightest and the best of the new doctors coming out of training. Larger practices may take some solace in the fact that new physicians are more likely to want the infrastructure and financial stability that they are offered, allowing them to focus less on operating a practice and more on the practice of medicine.