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A Snapshot of U.S. Physicians
Key Findings from the 2008 Health Tracking Physician Survey
Sept. 3, 2009
FURTHER INFORMATION, CONTACT:
Alwyn Cassil (202) 264-3484 or [email protected]
WASHINGTON, DCAlmost 75 percent of physicians were
accepting all or most new Medicare patients, the vast majority of physicians
contracted with managed care plans, and slightly fewer than six in 10 physicians
provided charity care in 2008, according to findings released today from the
nationally representative Center for Studying Health System Change (HSC) 2008
Health Tracking Physician Survey.
Funded by the Robert Wood Johnson Foundation, the 2008 Health Tracking Physician
Survey covers a wide variety of physician and practice dimensions, from basic
physician demographic information, practice organization and career satisfaction
to insurance acceptance, compensation arrangements and charity care provision.
The 2008 survey includes responses from more than 4,700 physicians who provide
at least 20 hours per week of direct patient care, and had a 62 percent response
rate. Because of changes in survey administration, results from the 2008 physician
survey cannot be compared to findings from earlier HSC Community Tracking Study
Physician Surveys. However, the 2008 physician survey establishes a new baseline
that will allow future tracking of how physicians organize and practice medicine.
"Physicians clinical decisions affect how up to 90 percent of every health
care dollar is spent, so understanding how physicians are organized and practice
medicine is critical for policy makers, especially as they engage in the most
serious discussion of comprehensive health care reform in 15 years," said
HSC President Paul B. Ginsburg, Ph.D.
The survey findings are detailed in a new HSC Data BulletinA Snapshot
of U.S. Physicians: Key Findings from the 2008 Health Tracking Physician Surveyavailable
here. Other key findings include:
- Almost three-quarters of U.S. physicians were men in 2008. But for physicians
under age 40, slightly more than 41 percent were women, signaling how the composition
of the physician workforce may change in the future.
- Three out of four physicians identified themselves as white, non-Hispanic,
while 3.8 percent were black, non-Hispanic, 5.3 percent were Hispanic and 17.2
percent were Asian or other races. However, among physicians under age 40, about
two-thirds were white and 33 percent were minority-black (4%), Hispanic (5.4%),
and Asian or other race (24%).
- Nearly one-third of physicians worked in solo or two-physician practices,
15 percent worked in groups of three to five physicians and 19 percent worked
in practices of six to 50 physicians.
- More than 80 percent of physicians surveyed worked full time, more than
half (53%) were 40 to 55 years old, and almost four in 10 have practiced medicine
for more than 20 years. Nine in 10 physicians were board certified, and 22 percent
received their medical training outside of the United States or Canada. Almost
40 percent were primary care physicians, 35 percent were medical specialists,
including psychiatrists, and 26 percent were surgeons, including obstetrician/gynecologists.
A slight majority of physicians (56%) were either full or part owners of their
practices, while 44 percent were employees or independent contractors.
- In 2008, 44 percent of physicians reported receiving some form of performance-adjusted
salary, for example an adjustment based on their own productivity. Roughly a
quarter indicated payment by fixed salary, and 20 percent received a share of
practice revenue. Productivity factors and overall practice financial performance
were the most common financial incentives affecting physicians compensation.
- Slightly more than half of physicians (53%) reported their practices
were accepting all or most new Medicaid patients; 28 percent reported accepting
no new Medicaid patients. Almost nine in 10 physicians (87%) reported their
practices were accepting all or most new privately insured patients, and almost
three-quarters (74%) reported their practices accept all or most new Medicare
- The vast majority of physicians (87%) had managed care contracts in
2008. Compared with physicians with one or more managed care contracts, physicians
without managed care contracts were more likely to have practiced for more than
20 years, work fewer than 40 hours per week, lack board certification, work
in solo or two-physician practices, live in the western United States and report
practicing in a "non-competitive" environment.
- In 2008, slightly fewer than six in 10 U.S. physicians (59%) reported
providing charity caredefined as free or reduced-cost careto patients in financial
need. On average, physicians who provided charity care provided 9.5 hours of
charity care in the month preceding the survey, which amounts to slightly more
than 4 percent of their time spent in all medically related activities.
The Center for Studying Health System Change is a nonpartisan policy research
organization committed to providing objective and timely research on the nations
changing health system to help inform policy makers and contribute to better
health care policy. HSC, based in Washington, D.C., is funded principally by
the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy