Tracking the changes in physician practice settings

To describe the relationships among types of practice settings and physician characteristics and to document changes in these relationships over time.

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.

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.

Practice settings were classified as traditional, government, group, or managed, based on ownership, practice type, group size, and managed care contracts.

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.

Between 1987 and 1991, there was a significant shift away from traditional physician practice settings toward organized practice settings.