The association between the organization of medical practice and primary care physician attitudes and practice orientations

This study was designed to identify the association between physiciansʹ practice settings and their attitudes and practice orientations. The data for the study were obtained through a cross-sectional survey of 385 primary care physicians in the service area of the Kansas Primary Care Network (PCN), a joint federal-state funded program begun in 1984 to provide medical services for Medicaid consumers. Analysis of variance tests are used to analyze the differences between physicians in the different practice organizations. The results show that older physicians are more likely to join solo practice organizations. Solo practitioners are less supportive of group practice, and are more likely to locate in affluent and low physician population counties than group practitioners. More female physicians practice in institutional settings than their male colleagues. Graduates of schools of osteopathic medicine are more likely than graduates of schools of allopathic medicine to practice in solo and single-specialty organizations. Institutional physicians are more receptive to capitation-based reimbursement arrangements, government involvement in health care delivery and financing, and have larger Medicaid case-loads than the physicians in the other practice organizations examined in the study.