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Tracking the changes in physician practice settings

R G Hughes1, L C Baker

  • 1Research and Evaluation Unit, Robert Wood Johnson Foundation, Princeton, NJ, USA.

Archives of Family Medicine
|September 1, 1995
PubMed
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Young physicians increasingly moved from traditional to organized practice settings, particularly managed care, between 1987 and 1991. This shift reflects changing physician career paths and practice environments.

Area of Science:

  • Health Services Research
  • Medical Practice Management
  • Physician Workforce Studies

Background:

  • Understanding physician practice setting trends is crucial for healthcare policy and planning.
  • Physician characteristics influence practice choices, impacting healthcare delivery.
  • Documenting shifts in practice settings over time reveals evolving professional landscapes.

Purpose of the Study:

  • To examine the associations between physician demographics and practice setting types.
  • To track changes in these relationships among young physicians from 1987 to 1991.

Main Methods:

  • Utilized data from two national telephone surveys of young physicians conducted in 1987 and 1991.
  • Employed a cohort-repeated cross-sectional design, including reinterviews of 1987 respondents in the 1991 survey.

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  • Classified practice settings into traditional, government, group, or managed categories based on ownership, type, size, and contracts.
  • Main Results:

    • Physician sex, race/ethnicity, specialty, and medical school background were significantly related to practice setting.
    • A notable decrease in traditional practice settings and a corresponding increase in organized settings, especially managed care, were observed between 1987 and 1991.

    Conclusions:

    • A significant migration of physicians from traditional to organized practice settings occurred between 1987 and 1991.
    • These findings highlight a dynamic evolution in physician practice environments during the late 20th century.