Variation in Practice Patterns of Early- and Later-Career Family Physicians.

Area of Science:

• Medical Education
• Health Workforce Studies
• Family Medicine Research

Background:

• Physician practice patterns evolve throughout a career.
• Understanding these changes is crucial for medical education and workforce planning.
• This study investigates practice trends in early- and later-career family physicians.

Purpose of the Study:

• To examine self-reported practice activity trends among early- and later-career family physicians.
• To compare practice types, including outpatient continuity, mixed inpatient/outpatient care, and hospitalist roles.
• To analyze factors associated with changes in practice type over a 3-year period.

Main Methods:

• Utilized data from the American Board of Family Medicine's National Graduate Survey (NGS) for early-career physicians and the Continuous Certification Questionnaire (CCQ) for later-career physicians.
• A longitudinal cohort analysis was conducted from 2016-2019 (NGS) and 2017-2020 (CCQ).
• Physicians were categorized by practice type: outpatient continuity only, mixed practice (outpatient and inpatient), or no outpatient continuity (e.g., hospitalist).

Main Results:

• The study included 8,492 NGS and 30,491 CCQ participants.
• A majority of physicians in both groups provided outpatient continuity (77%-81%).
• Early-career physicians were more likely to have mixed practices (approx. 25% vs. 16%).
• A decline in mixed practice frequency was observed in both early-career (34.21% to 27.10%) and later-career (23.88% to 19.33%) physicians.
• Metropolitan location and practice type changes were associated with leaving mixed practice.

Conclusions:

• Early-career family physicians more frequently engage in mixed inpatient and outpatient care compared to later-career physicians.
• Both early- and later-career physicians demonstrated a decrease in mixed practice frequency within a 3-year timeframe.
• These practice shifts have significant implications for patient access to care and the structure of medical education programs.