Tracking the changes in physician practice settings
R. G. Hughes and L. C. Baker
Research and Evaluation Unit, Robert Wood Johnson Foundation, Princeton, NJ, USA.
OBJECTIVE: To describe the relationships among types of practice settings
and physician characteristics and to document changes in these
relationships over time. DESIGN: Two national telephone surveys of randomly
selected young physicians were conducted in 1987 and 1991. The 1991 survey
included reinterviews of 1987 respondents, providing both cohort and
repeated cross-sectional data. PARTICIPANTS: The 1987 survey included data
on 5312 physicians who had between 2 and 6 years of practice experience and
were under age 41 years. The 1991 survey included data on 5002 physicians
under age 45 years and in practice between 2 and 10 years, including 2151
reinterviews of 1987 respondents. MAIN OUTCOME MEASURES: Practice settings
were classified as traditional, government, group, or managed, based on
ownership, practice type, group size, and managed care contracts. RESULTS:
Physician sex, race/ethnicity, specialty, and type of medical school were
related to the type of practice setting. Young physicians were less likely
to practice in traditional settings in 1991 than in 1987 and were more
likely to practice in organized practice settings, especially in managed
practices. CONCLUSION: Between 1987 and 1991, there was a significant shift
away from traditional physician practice settings toward organized practice
settings.
