Most physicians in 2026 practice in groups, and for many that is a smart strategic choice, not a fallback. Larger organizations absorb the payment cuts, paperwork and staffing problems that are pushing small practices to the edge.
The shift is steady and measurable. In the AMA’s 2024 Physician Practice Benchmark Survey, 47.4% of physicians worked in practices with 10 or fewer doctors, the first time that figure fell below half. In 2012 it was 61.4%, and in the early 1980s roughly 80%.
Group practice is not one thing. It ranges from a five-physician partnership to a 500-physician multispecialty group to a hospital-employed position. Here is why a physician might choose one in 2026, and how to choose well.
Seven reasons to choose group practice
Physicians who sold or joined larger practices cite the same three reasons year after year: better payer rates, access to costly resources, and help managing regulatory requirements. Those are real advantages, and there are more.
- Negotiating leverage with payers. A group with dozens of physicians and a large patient panel can push back on commercial contracts. A solo doctor usually takes the rate offered.
- Shared overhead. Rent, EHR licenses, billing staff, compliance officers and IT security are split many ways. Each physician’s share of fixed costs drops as the group grows.
- Someone else runs the business. Credentialing, prior authorizations, HR, payroll and coding audits are handled by professional managers. You get more of your time back for patients and family.
- Call coverage and real time off. Shared call means nights and weekends are predictable, and a two-week vacation does not close the practice.
- Capital for ancillaries and equipment. Groups can afford in-house imaging, labs, infusion suites, lasers or ambulatory surgery centers that would be too risky for one physician.
- Readiness for value-based care. Accountable care organizations, shared savings and risk contracts need scale, data analytics and care managers. CMS continues to push these models, and the 2026 fee schedule pays a slightly higher conversion factor to qualifying APM participants ($33.57 vs $33.40).
- Colleagues down the hall. Curbside consults, peer review, mentorship and shared learning make medicine less isolating and often safer.
For early-career physicians carrying student debt, a group also offers a predictable salary, benefits and a chance to learn the business before taking on ownership risk.
Not all groups are alike
Who owns the group shapes your pay, autonomy and long-term options more than its size does.
| Group type | Who owns it | Main upside | Main trade-off |
|---|---|---|---|
| Physician-owned single-specialty | Partner physicians | Partnership track and profit share; clinical decisions stay with doctors | Buy-in cost; partners carry business risk |
| Physician-owned multispecialty | Partner physicians | Internal referrals and broad ancillaries | Compensation politics across specialties |
| Hospital or health system | The health system | Stable salary, benefits, strong IT and admin support | Less say over schedules, staffing and referrals; RVU targets |
| Private equity-backed | Investors, often with physician minority stakes | Upfront payout for sellers; capital to grow | Pressure on margins; future resale; reduced compensation after the deal |
| Independent physician association (IPA) or clinically integrated network | Member practices | Group contracting and shared services while you keep your own practice | Looser benefits than a true merger; antitrust rules limit joint pricing |
The IPA or network option is worth a close look if you want leverage without giving up ownership. It is the middle ground between going solo and merging.
The trade-offs to weigh honestly
Group practice buys stability with some autonomy. Go in clear-eyed about what you give up.
- Less control. Schedules, staffing, vendors and sometimes clinical protocols are set by committee or management.
- Productivity pressure. RVU-based compensation can reward volume over time with patients.
- Restrictive contracts. Non-competes, tail coverage obligations and termination clauses can limit where you practice if you leave.
- Culture risk. Mergers and acquisitions can change leadership, priorities and pay formulas overnight.
- Capped upside. If you are a strong producer or build a profitable service line, the margin may not flow back to you.
None of these is a dealbreaker on its own. They are reasons to read every contract carefully and to choose the group as carefully as it chooses you.
Questions to ask before you sign
- Who owns the group today, and has ownership changed or been discussed in the last three years?
- How is compensation calculated, and how often has the formula changed?
- Is there a partnership track? What is the buy-in, and when is it offered?
- What does the non-compete cover in miles, time and specialty?
- Who pays for malpractice tail coverage if you leave?
- How is call divided, and how is vacation scheduled?
- How much input do physicians have on staffing, scheduling and new services?
- What is physician turnover over the past five years, and why did people leave?
- Can you speak privately with two or three current physicians?
Have a healthcare attorney review the contract before you sign. The fee is small compared with the cost of a bad non-compete.
The bottom line
Group practice in 2026 makes the most sense for physicians who want to focus on clinical work, value predictable income and time off, or practice in a specialty that needs capital and scale. The right group gives you leverage, support and colleagues without asking you to give up your standards.
The key is fit. Choose a group whose ownership, culture and compensation model match your goals, and negotiate your contract as seriously as any clinical decision.
Sources
- AMA: Physician private practice “unraveling”, Medical Economics, May 2025
- Dive Into the 2026 Medicare Physician Fee Schedule Final Rule, American College of Cardiology, Nov 2025