Is bigger always better? The optimal size of a group practice

Douglas E. Hough

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


The past decade saw several attempts to consolidate physician practices, but this sector remains one of the last cottage indusries in the United States. This article develops a framework for analyzing the optimal size of a physician practice. The framework addresses technological factors (e.g., economies of scale and scope), behavioral factors (e.g., changing physician goals, costs of organizing and operating a practice), and market-riven factors (e.g., managed care contracting). Existing empirical research suggests three "optimal" sizes of practices: 5-10 physicians, based on economies of scale and decision-making; 20-30 physicians, based on economies of scope and initial development of a corporate structure; and 80+ (multi-specialty) physicians, which can create an system of referrals and utilization. The article concludes with observations about the challenges to physician practices as they grow.

Original languageEnglish (US)
Pages (from-to)312-318
Number of pages7
JournalJournal of Medical Practice Management
Issue number6
StatePublished - Jul 6 2002


  • Economies of scale
  • Physician practice
  • Practice growth

ASJC Scopus subject areas

  • Health Policy


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