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Physician employment status and practice patterns

G E Kikano1, M A Goodwin, K C Stange

  • 1Department of Family Medicine, Case Western Reserve University, Cleveland, OH, USA. gek@po.cwru.edu

The Journal of Family Practice
|June 25, 1998
PubMed
Summary
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Employed physicians, often female, work fewer hours but spend more time per patient, focusing on history-taking and preventive care. Patient satisfaction remains similar regardless of employment status.

Area of Science:

  • Health Services Research
  • Physician Workforce Studies
  • Primary Care Medicine

Background:

  • A significant number of physicians are now employed rather than self-employed.
  • Understanding the differences between employed and self-employed physicians is crucial.

Purpose of the Study:

  • To compare the characteristics, practice patterns, and patient outcomes of self-employed versus employed physicians.
  • To investigate how employment status influences physician time allocation and service delivery.

Main Methods:

  • A cross-sectional study of 108 community family physicians in northeast Ohio.
  • Data collected via physician questionnaires, direct observation of 3536 patient visits, and patient satisfaction surveys.

Main Results:

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  • Employed physicians were more likely female, worked fewer hours, and saw fewer patients.
  • Employed physicians spent more time per visit, prioritized well-care visits, and were more likely to refer to specialists.
  • Employed physicians dedicated more time to history-taking and less to physical exams, treatment planning, education, and chatting; they delivered more recommended preventive services.
  • Patient satisfaction was comparable between employed and self-employed physicians, though employed physicians reported higher satisfaction with leisure and family time.

Conclusions:

  • Physician characteristics and practice patterns vary significantly based on employment status.
  • The increasing trend towards an employed physician workforce warrants careful consideration of its implications.