Skip to main content

Advertisement

Log in

A cross-sectional analysis of trends in dermatology practice size in the United States from 2012 to 2020

  • Original Paper
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Physicians are trending towards practice consolidation nationally; however, changes in dermatology practice size remain to be assessed. The objective of this study was to analyze trends in dermatology practice size from 2012 to 2020 using a large-scale Medicare physician database. We performed a retrospective cross-sectional analysis using 2012 and 2020 data obtained from the Physician Compare Database. Responses from dermatologists were analyzed for trends in practice size, with a sub-analysis to examine differences among different regions, gender, and years of experience. The proportion of dermatologists in solo practice decreased from 26.1% in 2012 to 15.6% in 2020 (p < 0.001). Dermatologists were 40% less likely to be practicing in solo practice and 36% more likely to be in a practice with 10 or more members in 2020 (p < 0.001). These findings were consistent among all regions and genders examined. Additionally, in 2020, dermatologists with 30 or more years in practice were 7.5 times more likely to be in solo practice compared to dermatologists with 0–9 years in practice (p < 0.001). There is a trend of dermatologists working for larger practices, which is consistent with a larger nationwide trend of expanding physician practices. This shift in practice settings should be closely monitored to analyze the effect on healthcare efficiency, cost, and delivery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Not applicable.

Code availability

Not applicable.

References

  1. Hirsch JA, Rosenkrantz AB, Ansari SA, Manchikanti L, Nicola GN (2017) MACRA 2.0: are you ready for MIPS? J NeuroInterventional Surg 9(7):714–716. https://doi.org/10.1136/neurintsurg-2016-012845

    Article  Google Scholar 

  2. Kanter GP, Polsky D, Werner RM (2019) Changes in physician consolidation with the spread of accountable care organizations. Health Aff 38(11):1936–1943. https://doi.org/10.1377/hlthaff.2018.05415

    Article  Google Scholar 

  3. West J, Johnson G, Jha AK (2017) Trends in acquisitions of physician practices and subsequent clinical integration: a mixed methods study. J Eval Clin Pract 23(6):1444–1450. https://doi.org/10.1111/jep.12820

    Article  PubMed  Google Scholar 

  4. Muhlestein DB, Smith NJ (2016) Physician consolidation: rapid movement from small to large group practices, 2013–15. Health Aff 35(9):1638–1642. https://doi.org/10.1377/hlthaff.2016.0130

    Article  Google Scholar 

  5. Nikpay SS, Richards MR, Penson D (2018) Hospital-physician consolidation accelerated in the past decade in cardiology. Oncol Health Affairs 37(7):1123–1127. https://doi.org/10.1377/hlthaff.2017.1520

    Article  Google Scholar 

  6. O’Hanlon CE, Whaley CM, Freund D (2019) Medical practice consolidation and physician shared patient network size, strength, and stability. Med Care 57(9):680–687. https://doi.org/10.1097/MLR.0000000000001168 (PMID: 31295166)

    Article  PubMed  Google Scholar 

  7. Cutler DM, Scott MF (2013) Hospitals, market share, and consolidation. JAMA 310(18):1964–1970. https://doi.org/10.1001/jama.2013.281675

    Article  CAS  PubMed  Google Scholar 

  8. Physician compare national downloadable file | Data.Medicare.gov. https://data.medicare.gov/Physician-Compare/Physician-Compare-National-Downloadable-File/mj5m-pzi6 Accessed 12 July 2020

  9. Physician compare data FAQ | CMS.gov. cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/physician-compare-initiative/Physician-Compare-Data-FAQ-#What%20is%20Physician%20Compare’s%20primary%20data%20source? Accessed 1 June 2021

  10. Rosenkrantz AB, Fleishon HB, Silva E, Bender CE, Duszak R (2020) radiology practice consolidation: fewer but bigger groups over time. J Am Coll Radiol 17(3):340–348. https://doi.org/10.1016/j.jacr.2019.02.030

    Article  PubMed  Google Scholar 

  11. Kane CK (2015) Policy research perspectives: updated data on physician practice arrangements: inching toward hospital ownership. The American Medical Association Policy Research Perspectives. http://www.ama-assn.org/resources/doc/health-policy/x-pub/prp-practice-arrangement-2015.pdf. Accessed Oct 2020

  12. Broker B. Physicians post-PPACA: Not going bust at the healthcare buffet (conclusion). Physicians News. https://physiciansnews.com/2012/04/01/physicians-post-ppaca-not-going-bust-at-the-healthcare-buffet-conclusion/ Accessed 26 December 2020

  13. Tan S, Seiger K, Renehan P, Mostaghimi A (2019) Trends in Private Equity Acquisition of Dermatology Practices in the United States. JAMA Dermatol 155(9):1013. https://doi.org/10.1001/jamadermatol.2019.1634

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kocher R, Sahni NR (2011) Hospitals’ race to employ physicians—the logic behind a money-losing proposition. N Engl J Med 364(19):1790–1793. https://doi.org/10.1056/NEJMp1101959

    Article  CAS  PubMed  Google Scholar 

  15. Gronbeck C, Feng PW, Feng H (2020) Participation and performance of dermatologists in the 2017 merit-based incentive payment system. JAMA Dermatol 156(4):466–468. https://doi.org/10.1001/jamadermatol.2019.4860

    Article  PubMed  PubMed Central  Google Scholar 

  16. O’Hanlon CE, Whaley CM, Freund D (2019) Medical practice consolidation and physician shared patient network size, strength, and stability. Med Care 57(9):680–687. https://doi.org/10.1097/MLR.0000000000001168

    Article  PubMed  Google Scholar 

  17. Neprash HT, Chernew ME, McWilliams JM (2017) Little evidence exists to support the expectation that providers would consolidate to enter new payment models. Health Aff 36(2):346–354. https://doi.org/10.1377/hlthaff.2016.0840

    Article  Google Scholar 

  18. Hearing on health care industry consolidation. ways and means republicans. Published September 9, 2011. https://gop-waysandmeans.house.gov/hearing-on-health-care-industry-consolidation/ Accessed 26 December 2020

  19. Roberts ET, Mehrotra A, McWilliams JM (2017) High-price and low-price physician practices do not differ significantly on care quality or efficiency. Health Aff (Millwood) 36(5):855–864. https://doi.org/10.1377/hlthaff.2016.1266

    Article  PubMed  Google Scholar 

  20. Koch T, Wendling B, Wilson NE (2018) Physician market structure, patient outcomes, and spending: an examination of Medicare beneficiaries. Health Serv Res 53(5):3549–3568. https://doi.org/10.1111/1475-6773.12825

    Article  PubMed  PubMed Central  Google Scholar 

  21. Total Expenditures per Patient in Hospital-Owned and Physician-Owned Physician Organizations in California | Clinical Pharmacy and Pharmacology | JAMA | JAMA Network. https://jamanetwork.com/journals/jama/fullarticle/1917439 Accessed 15 April 2021

  22. McWilliams JM, Chernew ME, Zaslavsky AM, Hamed P, Landon BE (2013) delivery system integration and health care spending and quality for Medicare beneficiaries. JAMA Intern Med 173(15):1447–1456. https://doi.org/10.1001/jamainternmed.2013.6886

    Article  PubMed  PubMed Central  Google Scholar 

  23. Resneck JS Jr (2018) Dermatology practice consolidation fueled by private equity investment: potential consequences for the specialty and patients. JAMA Derm 154(1):13–14. https://doi.org/10.1001/jamadermatol.2017.5558

    Article  Google Scholar 

  24. Active physicians with a US. Doctor of medicine (US. MD) degree by specialty, 2019. AAMC. Published 2020. https://www.aamc.org/data-reports/workforce/interactive-data/active-physicians-us-doctor-medicine-us-md-degree-specialty-2019 Accessed 16 December 2021

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shawn G. Kwatra.

Ethics declarations

Conflict of interest

None.

Ethical approval

IRB approval status exempt.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 19 KB)

Supplementary file2 (DOCX 91 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Parthasarathy, V., Pollock, J.R., McNeely, G.L. et al. A cross-sectional analysis of trends in dermatology practice size in the United States from 2012 to 2020. Arch Dermatol Res 315, 223–229 (2023). https://doi.org/10.1007/s00403-022-02344-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00403-022-02344-0

Keywords

Navigation