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The National Library of Medicine defines medical group practice1as: “Any group of three or more full-time physicians organized in a legally recognized entity for the provision of healthcare services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.” Medical group practice—which also may refer to collaborative medical work by physicians—is grounded in the social and economic, as well as the preventive and curative practices of physicians. The physician’s role as a healer has had many different facets since prehistory. From shaman to herbalist to surgeon to specialist, the role of the physician has been intertwined with social, economic, scientific, and technological change.

Throughout most of Western history—albeit, with some notable exceptions—physicians have had solo practices. However, beginning in the eighteenth century and accelerating rapidly in the nineteenth and twentieth centuries, several forces radically changed not only what physicians were capable of accomplishing, but also how and where their services could be accomplished in the United States and in Europe.

This chapter examines changes in the physician’s role and traces the emergence of medical group practice in the United States and other industrialized nations. It is divided into three sections:

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