Logan Reid
Doctors are employed by a variety of organisations, including hospitals, clinics, universities, and other corporate entities. In the US, the majority of physicians are employed by hospitals, health systems, or corporate entities, with around 77% of doctors falling into this category as of 2024. This marks a shift away from independent practice, with the number of doctors employed by hospitals increasing by 5.1% between 2022 and 2023. Doctors employed by hospitals work in a range of roles, from foundation year residents to consultants, who are the most senior grade of hospital doctors. They may also work in both clinical and non-clinical settings, with clinical settings including physicians' offices and hospitals, and non-clinical settings such as government agencies and insurance companies.
| Characteristics | Values |
|---|---|
| Number of physicians employed by hospitals | 77.6% as of 2023 |
| Number of physicians employed by hospitals and other corporate entities | 77% |
| Number of physicians employed by hospitals, payers, pharmacy chains, or other corporate entities | 80% as of January 1, 2024 |
| Number of physicians employed by hospitals or corporate entities in 2022 | 73.9% |
| Number of physicians employed by hospitals or corporate entities in 2012 | 25.8% |
| Number of physician practices owned by hospitals and health systems | 28.4% as of January 1, 2024 |
| Number of physician practices owned by hospitals and corporate entities | 58.5% |
| Number of physician jobs in 2023 | 834,500 |
| Average duration of residency | 3 to 9 years |
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What You'll Learn
Types of doctors: consultants, SAS doctors, GPs, etc
There are several types of doctors, each with distinct roles and responsibilities. Here is an overview of some of the common types:
Consultants
Consultants are senior doctors who have completed full medical training in a specialised field of medicine. They are listed on the GMC's specialist register and hold the most senior grade among hospital doctors. They are responsible for leading a team and managing other doctors, such as SAS and resident doctors. Every patient admitted to the hospital will have a named consultant. Becoming a consultant typically takes around seven to ten years after graduating from medical school.
SAS Doctors
SAS stands for Specialist, Associate Specialist, and Specialty. SAS doctors are experienced doctors holding permanent posts. They usually have at least four years of full-time postgraduate experience, with two years in their relevant specialty. Some SAS doctors may also have twelve or more years of experience, with six years in their specialty. SAS doctors often work across primary, community, and hospital care, and they may also work part-time as GPs. This career path offers a good work-life balance and provides a focus on direct patient care rather than administrative tasks.
GPs (General Practitioners)
GPs are generalist doctors who provide primary care to patients. They often work in community settings, but some may also work part-time in hospitals. Becoming a GP typically involves a five-year undergraduate course or a four-year postgraduate course, followed by further clinical training.
Locum Doctors
Locum doctors are fully qualified doctors who temporarily cover positions. They can be foundation year two resident doctors, resident doctors in specialty training, SAS doctors, GPs, or consultants. Locum positions are often used to cover for sick leave or to manage high workloads.
Academic Doctors
Academic doctors combine teaching and research with clinical care. They can be any grade of doctor, from foundation year residents to consultants, GPs, or SAS doctors. They undertake research to advance medical science and are often involved in teaching and service development.
It is worth noting that the employment landscape for doctors is evolving. There has been a notable shift towards physicians being employed by hospitals or other corporate entities, with a corresponding decline in independent physicians. As of 2024, nearly 80% of physicians were employed by hospitals or other corporate entities, a trend that has been fuelled by hospitals in recent years.
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Doctors' employment settings: clinical vs non-clinical
Physicians and surgeons work in both clinical and non-clinical settings. Clinical settings include physicians' offices, hospitals, and academic hospitals associated with residency programs or schools of medicine. In clinical settings, physicians may work as part of a group practice or healthcare organisation, allowing them to coordinate patient care but with less independence than solo practitioners.
Non-clinical settings for physicians and surgeons include government agencies, nonprofit organisations, and insurance companies.
In hospitals, doctors hold various roles with different levels of seniority. Consultants are the most senior grade of hospital doctors and are responsible for leading a team. Every patient admitted to the hospital will have a named consultant. SAS doctors (specialist, associate specialist, and specialty doctors) are experienced doctors in permanent posts with a very ''hands-on'' role and a lot of patient contact. Resident doctors are qualified doctors in clinical training who have completed a medical degree and gained working experience. They provide direct care under the supervision of an attending physician or senior resident.
The trend of physicians being employed by hospitals or corporate entities has been increasing. As of 2024, nearly 80% of physicians are employed by hospitals, health systems, or corporate entities, marking a decadelong shift away from independent practice. This shift has been attributed to various factors, including the COVID-19 pandemic, which drove physicians toward employers for stable income, and the aggressive acquisition of physician practices by health systems and corporate entities.
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Doctors' training: medical school, internships, residency, fellowship
The path to becoming a doctor is a long one, and there are several steps that must be taken. These include medical school, internships, residencies, and fellowships.
Medical school typically involves a five-year course of study for undergraduate students or a four-year postgraduate course. The first two years are spent studying basic medical sciences, followed by three years of more clinical training, working in hospital wards under the supervision of consultants.
After graduating from medical school, the next step is to complete an internship. An intern is a resident in their first year of training after medical school. This usually takes place in a hospital or clinic and provides further training in a chosen specialty. During this time, interns may rotate through different specialties or different areas within one specialty.
Following the internship, doctors will enter a residency program. A residency is a training program that usually lasts from three to seven years, depending on the specialty. During this time, residents continue to receive supervision from attending physicians or senior residents while providing direct care to patients. Residents may also start to write prescriptions for those under their care as part of their training.
After completing their residency, some doctors may choose to pursue a fellowship. Fellowships are designed for highly specialized training in a particular area of medicine. During a fellowship, doctors are considered fully licensed physicians and will receive a higher salary. They may even have residents under their supervision.
It is important to note that the specific requirements and durations of each training stage may vary depending on the country and specialty chosen. Additionally, the employment landscape for physicians is diverse, with many doctors working in hospitals, academic institutions, government agencies, and private practices.
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Doctors' titles: Mr, Mrs, Miss, Ms, Professor, Dr
In the English language, an honorific is a title that conveys courtesy or respect. Doctors, depending on their qualifications, gender, and specialty, may use different titles.
Doctors who perform surgery may use the titles 'Mr', 'Mrs', 'Miss', or 'Ms' instead of 'Dr' due to historical reasons. The titles 'Mr', 'Mrs', 'Miss', and 'Ms' are used to show respect and are typically placed before a person's name. 'Mr' is used for men and boys, while 'Mrs' is used for married women. 'Miss' is used for unmarried women and young girls, or when a woman's marital status is unknown or unimportant. 'Ms' is a gender-neutral alternative to 'Miss' and 'Mrs', used for women regardless of their marital status.
Doctors who are university professors may use the title 'Professor' instead of 'Dr'. The title 'Professor' is an academic rank held by a person in a university or other institution.
It is important to note that the use of titles may vary depending on the country and cultural context. For example, in some countries, it is normal to address surgeons as 'Mr', 'Ms', or other gender-neutral alternatives.
In terms of employment, physicians and surgeons work in both clinical and non-clinical settings. Clinical settings include hospitals, physicians' offices, and academic hospitals with residency programs. In recent years, there has been a shift towards more physicians and surgeons being employed by hospitals or other corporate entities, with nearly 80% of doctors falling into this category as of 2024. This shift may be influenced by factors such as stable income, ownership percentages, and the impact of the COVID-19 pandemic on revenue and practice ownership.
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Doctors' employers: hospitals, health systems, corporate entities
Physicians and surgeons work in both clinical and non-clinical settings. Clinical settings include physicians' offices and hospitals, including academic hospitals associated with residency programs or schools of medicine. In non-clinical settings, physicians may work for government agencies, non-profit organizations, or insurance companies.
In clinical settings, physicians may work as part of a group practice or healthcare organization, coordinating patient care. These arrangements offer less independence than solo practitioners. In hospitals, physicians are often supervised by attending physicians or senior residents.
The majority of doctors are employed by hospitals, health systems, or corporate entities. As of 2024, more than 77% of physicians in the US are employed by these entities, a number that has been steadily increasing over the past decade. This shift away from independent practice has been accelerated by the COVID-19 pandemic, with hospitals and corporate entities acquiring physician practices.
While hospitals and health systems owned 28.4% of physician practices as of January 2024, corporate entities, including payers, private equity firms, and large pharmacy chains, owned 30.1%. This shift has raised concerns about the potential conflict between the ethical responsibility of physicians to their patients and the profit-driven motives of corporate entities.
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Frequently asked questions
University doctors are employed by hospitals, health systems or corporate entities. As of 2024, nearly 80% of physicians are employed by hospitals.
University doctors are doctors who teach at a university. They may also work in hospitals. Hospital doctors, on the other hand, are primarily based in a hospital and may have different specialisations, such as surgery or anaesthesiology.
Not necessarily. University doctors are often highly experienced and qualified, but hospital doctors can also have extensive experience and specialisations. Seniority in hospitals is denoted by titles such as resident, fellow, and attending.
Yes, doctors can work in both hospitals and universities. Physicians and surgeons often work in both clinical and non-clinical settings. Clinical settings include hospitals and academic hospitals with residency programs, while non-clinical settings can be government agencies or insurance companies.
