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Why physicians choose different types of practice settings

F D Wolinsky

    Health Services Research
    |January 1, 1982
    PubMed
    Summary
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    Physicians choose practice settings based on peer regulation likelihood. Large group practices offer the most regulation, while solo practices offer the least, influencing career preferences.

    Area of Science:

    • Sociology of Medicine
    • Health Services Research

    Background:

    • Physician practice settings significantly influence healthcare delivery dynamics.
    • Freidson's typology of medical practice settings provides a framework for analysis.
    • Understanding physician preferences for practice settings is crucial for healthcare system planning.

    Purpose of the Study:

    • To extend Freidson's typology of medical practice settings into three categories: solo, small group, and large group practices.
    • To investigate the relationship between practice setting size and the probability of effective peer regulation.
    • To develop and empirically test an analytic model predicting physician practice choices based on practice setting preferences.

    Main Methods:

    • Modification of Freidson's original typology into three distinct medical practice settings.

    Related Experiment Videos

  • Sociological analysis focusing on the differential probability of peer regulation across practice settings.
  • Empirical assessment using data from a 1979 national survey of approximately 4,500 physicians.

    • Main Results:

    • A clear hierarchy of peer regulation probability exists: highest in large group practices, lowest in solo practices.
    • Physicians' practice choices are influenced by their preferences for specific levels of peer regulation.
    • The analytic model effectively predicts physician practice settings based on sociodemographic, environmental, and attitudinal factors.

    Conclusions:

    • The extended Freidsonian theory offers valuable insights into physician practice setting selection.
    • Physician preferences for peer regulation significantly shape the configuration of the American healthcare delivery system.
    • Findings have implications for the strategic development of health maintenance organizations and other healthcare models.