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Research ArticleOriginal Research

The Association of Practice Type and the Scope of Care of Family Physicians

David Killeen, Anuradha Jetty, Lars E. Peterson, Andrew Bazemore and Yalda Jabbarpour
The Journal of the American Board of Family Medicine December 2022, jabfm.2022.220172R1; DOI: https://doi.org/10.3122/jabfm.2022.220172R1
David Killeen
From University of Pennsylvania, Philadelphia, PA (DK); Robert Graham Center, Washington, DC(AJ, YJ); American Board of Family Medicine, Lexington, KY(LEP, AB); and Center for Professionalism & Value in Health Care, Washington, DC (AB).
MD, MEd
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Anuradha Jetty
From University of Pennsylvania, Philadelphia, PA (DK); Robert Graham Center, Washington, DC(AJ, YJ); American Board of Family Medicine, Lexington, KY(LEP, AB); and Center for Professionalism & Value in Health Care, Washington, DC (AB).
MPH
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Lars E. Peterson
From University of Pennsylvania, Philadelphia, PA (DK); Robert Graham Center, Washington, DC(AJ, YJ); American Board of Family Medicine, Lexington, KY(LEP, AB); and Center for Professionalism & Value in Health Care, Washington, DC (AB).
MD, PhD
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Andrew Bazemore
From University of Pennsylvania, Philadelphia, PA (DK); Robert Graham Center, Washington, DC(AJ, YJ); American Board of Family Medicine, Lexington, KY(LEP, AB); and Center for Professionalism & Value in Health Care, Washington, DC (AB).
MD, MPH
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Yalda Jabbarpour
From University of Pennsylvania, Philadelphia, PA (DK); Robert Graham Center, Washington, DC(AJ, YJ); American Board of Family Medicine, Lexington, KY(LEP, AB); and Center for Professionalism & Value in Health Care, Washington, DC (AB).
MD
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Article Figures & Data

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    Figure 1.

    Proportion of family physicians reporting provision of women’s health services. Abbreviations: RHC, Rural Health Center; AHC, Academic Health Center; FQHC, Federally Qualified Health Center.

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    Figure 2.

    Proportion of family physicians reporting providing children’s health services. Abbreviations: RHC, Rural Health Center; AHC, Academic Health Center; FQHC, Federally Qualified Health Center.

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    Figure 3.

    Proportion of family physicians reporting performing select procedures. Abbreviations: RHC, Rural Health Center; AHC, Academic Health Center; FQHC, Federally Qualified Health Center.

Tables

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    Table 1.

    Distribution of Demographic and Practice Characteristics of Family Physicians in the Analysis

    Characteristicsn%
    Gender
    Female9,68738.6
    Male15,43061.4
    Years in Practice
    0 to 10 years6,45925.7
    11 to 20 years8,44033.6
    21 to 30 years7,20328.7
    31 years or more3,01512
    Race/Ethnicity
    White, Non-Hispanic18,51273.7
    Black, Non-Hispanic1,4825.9
    Asian, Non-Hispanic3,22312.8
    Other, Non-Hispanic1070.4
    Hispanic1,4635.8
    Census Region
    Northeast3,71814.8
    South9,10436.2
    West5,31121.1
    Midwest6,98427.8
    Rurality of practice
    Rural4,68018.6
    Urban20,43781.4
    Practice Specialty Mix
    Single16,51765.8
    Multi8,60034.2
    Practice Size
    Solo3,35213.3
    Small8,85935.3
    Medium8,04932.0
    Large4,58818.3
    Other2691.1
    Practice Organization
    Hospital- owned4,11616.4
    Solo practice2,88311.5
    Group practice9,63338.4
    Managed care9743.9
    Academic health center1,4015.6
    Federally Qualified Health Center1,2955.2
    Rural Health Center6752.7
    Other Safety net6302.5
    Federal1,1314.5
    Urgent care7302.9
    Other1,6496.6
    Patient-Centered Medical Home
    Yes8,29633.0
    No11,12344.3
    No, Applied5,69822.7
    • Notes: Data Source: American Board of Family Medicine, Family Medicine Certification Examination practice demographic registration questionnaire data (n = 25,117), sample restricted to Family Physicians in direct patient care.

    • View popup
    Table 2.

    Unadjusted and Adjusted Mean Individual Scope of Practice (SOP) by Practice Organization*

    UnadjustedAdjusted
    Practice OrganizationMean (95% CI)Mean (95% CI)
    Rural Health Center17.6 (17.4 to 17.9)16.6 (16.4 to 16.7)
    Academic health center16.6 (16.4 to 16.7)16.2 (16.1 to 16.3)
    Federally Qualified Health Center15.9 (16.4 to 16.7)15.3 (15.2 to 15.5)
    Group practice15.8 (15.8 to 16.1)15.6 (15.5 to 15.6)
    Hospital-owned15.1 (15.0 to 15.1)15.0 (14.9 to 15.1)
    Solo practice15.0 (14.9 to 15.1)16.2 (15.9 to 16.4)
    Managed care15.0 (14.8 to 15.1)14.8 (14.6 to 15.0)
    Urgent care14.1 (13.9 to 14.3)14.9 (14.7 to 15.1)
    Federal13.8 (13.6 to 13.9)13.8 (13.7 to 14.0)
    Other Safety-net13.5 (13.3 to 13.7)13.9 (13.7 to 14.0)
    Other13.3 (13.1 to 13.4)13.8 (13.7 to 14.0)
    • Abbreviation: CI, confidence interval.

    • Data Source: American Board of Family Medicine, Family Medicine Certification Examination practice demographic registration questionnaire data (n = 25,117), sample restricted to Family Physicians in direct patient care *Adjusted for gender, years in practice, race, region and rurality of practice location, practice size, patient-centered Medical Home (PCMH) status, primary specialty mix and proportion of county population living below 200%Federal Poverty Level (FPL) (1) Rural Health Center, (2) Academy Health Center, (3) Federally Qualified Health Center, (4) Group practice (5) Hospital-owned (hospital emergency department and outpatient department, (6) Solo practice (7) Managed care (HMO [Kaiser Permanente]), (8) Urgent care center(Freestanding), (9) Federal (Military, Veteran Administration/Department of Defense and Indian Health Service), (10) Other safety net (Institutional setting (School-based clinic, nursing home, prison and non-federal government clinic (e.g. state, county, city, maternal and child health, etc.,), and (11) Other (ambulatory surgical center, public health service, industrial outpatient facility and mental health center).

    • View popup
    Appendix Table 1.

    Proportion of Family Physicians Providing Other Care Including Pain Management, Hospital Medicine, and Palliative Care

    Practice OrganizationPain ManagementHospital MedicinePalliative Care
    n%n%n%
    Rural Health Center52678.042563.053279.0
    Academic health center1,02373.087362.079757.0
    Federally Qualified Health Center94473.038330.063849.0
    Group practice6,21164.02,91330.05,31255.0
    Hospital-owned2,31356.01,09427.01,83245.0
    Solo practice1,58255.01,03736.01,48451.0
    Managed care74476.018719.043445.0
    Urgent care13318.0223.0497.0
    Federal83373.023220.043338.0
    Other safety net36458.014323.025240.0
    Other88754.063338.075646.0
    • View popup
    Appendix Table 2.

    Proportion of Family Physicians Provision of Other Services

    Practice OrganizationAcute Care/Same Day AppointmentExtended Hours
    Rural Health Center654979659
    Academic health center1,2819121968
    Federally Qualified Health Center1,2429628984
    Group practice9,104951,54270
    Hospital-owned3,7609169073
    Solo practice2,6189135053
    Managed care9089320485
    Urgent care7059716092
    Federal1,0018814557
    Other Safety net546878159
    Other1,1436923666
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The Journal of the American Board of Family     Medicine: 37 (6)
The Journal of the American Board of Family Medicine
Vol. 37, Issue 6
November-December 2024
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The Association of Practice Type and the Scope of Care of Family Physicians
David Killeen, Anuradha Jetty, Lars E. Peterson, Andrew Bazemore, Yalda Jabbarpour
The Journal of the American Board of Family Medicine Dec 2022, jabfm.2022.220172R1; DOI: 10.3122/jabfm.2022.220172R1

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The Association of Practice Type and the Scope of Care of Family Physicians
David Killeen, Anuradha Jetty, Lars E. Peterson, Andrew Bazemore, Yalda Jabbarpour
The Journal of the American Board of Family Medicine Dec 2022, jabfm.2022.220172R1; DOI: 10.3122/jabfm.2022.220172R1
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