Divisional Variation of Clinician, Practice, Community, and Healthcare Market Characteristics of Mid to Late Career Family Physicians, 2017 to 2022
| East North Central | East South Central | Middle Atlantic | Mountain | New England | Pacific | South Atlantic | West North Central | West South Central | Full Population | |
|---|---|---|---|---|---|---|---|---|---|---|
| Scope of practice score Mean (SD) | 13.68 (3.51) | 12.63 (3.81) | 12.59 (3.54) | 13.42 (3.86) | 13.20 (3.44) | 12.26 (3.75) | 11.49 (3.62) | 14.95 (3.98) | 12.20 (3.82) | 12.77 (3.83) |
| Domain 1: Clinician | ||||||||||
| Age Mean (SD) | 50.08 (9.39) | 50.37 (9.65) | 50.54 (9.72) | 50.04 (8.94) | 51.04 (9.45) | 49.45 (9.06) | 50.56 (9.39) | 50.22 (9.29) | 49.46 (9.09) | 50.09 (9.31) |
| Gender (percent) | ||||||||||
| Female | 2,588 (45.2%) | 711 (37.1%) | 1,683 (48.5%) | 1,251 (42.2%) | 832 (52.5%) | 3,464 (50.5%) | 3,002 (44.1%) | 1,432 (43.0%) | 1596 (38.8%) | 16,559 (45.0%) |
| Race (percent) | ||||||||||
| American Indian or Alaska Native | 31 (0.5%) | 12 (0.6%) | 12 (0.3%) | 44 (1.5%) | 8 (0.5%) | 62 (0.9%) | 48 (0.7%) | 35 (1.1%) | 59 (1.4%) | 311 (0.8%) |
| Asian | 881 (15.4%) | 179 (9.3%) | 657 (19.0%) | 277 (9.3%) | 201 (12.7%) | 1,867 (27.2%) | 1,028 (15.1%) | 261 (7.8%) | 775 (18.8%) | 6,126 (16.7%) |
| Black or African American | 277 (4.8%) | 188 (9.8%) | 225 (6.5%) | 66 (2.2%) | 51 (3.2%) | 223 (3.3%) | 854 (12.6%) | 93 (2.8%) | 320 (7.8%) | 2,297 (6.2%) |
| Native Hawaiian or Pacific Islander | 20 (0.3%) | 1 (0.1%) | 12 (0.3%) | 17 (0.6%) | 5 (0.3%) | 85 (1.2%) | 28 (0.4%) | 9 (0.3%) | 17 (0.4%) | 194 (0.5%) |
| White | 4,222 (73.7%) | 1,464 (76.4%) | 2,347 (67.7%) | 2,388 (80.5%) | 1,254 (79.1%) | 3,943 (57.5%) | 4,423 (65.0%) | 2,823 (84.8%) | 2,696 (65.5%) | 25,560 (69.5%) |
| Other | 298 (5.2%) | 71 (3.7%) | 214 (6.2%) | 174 (5.9%) | 66 (4.2%) | 673 (9.8%) | 419 (6.2%) | 109 (3.3%) | 248 (6.0%) | 2,272 (6.2%) |
| Ethnicity (percent) | ||||||||||
| Hispanic or Latino | 239 (4.2%) | 39 (2.0%) | 180 (5.2%) | 232 (7.8%) | 61 (3.8%) | 641 (9.4%) | 642 (9.4%) | 92 (2.8%) | 542 (13.2%) | 2,668 (7.3%) |
| International medical graduate status (percent) | ||||||||||
| International medical graduate | 1,367 (24.2%) | 331 (17.4%) | 1,056 (31.1%) | 439 (14.9%) | 303 (19.3%) | 1,721 (25.4%) | 1,926 (28.7%) | 401 (12.1%) | 1,112 (27.3%) | 8,656 (23.8%) |
| Degree type, MD versus DO (percent) | ||||||||||
| DO degree | 610 (10.6%) | 188 (9.8%) | 480 (13.8%) | 447 (15.1%) | 191 (12.1%) | 740 (10.8%) | 559 (8.2%) | 466 (14.0%) | 412 (10.0%) | 4,093 (11.1%) |
| Residency location (percent) | ||||||||||
| Small rural | 2 (0.0%) | 27 (1.5%) | 3 (0.1%) | 1 (0.0%) | 0 (0%) | 1 (0.0%) | 8 (0.1%) | 0 (0%) | 8 (0.2%) | 50 (0.2%) |
| Large rural | 161 (3.1%) | 175 (9.8%) | 51 (1.6%) | 78 (3.0%) | 110 (7.4%) | 123 (1.9%) | 219 (3.6%) | 153 (5.2%) | 105 (3.0%) | 1,175 (3.5%) |
| Urban | 5,026 (96.9%) | 1,580 (88.7%) | 3,191 (98.3%) | 2,524 (97.0%) | 1,368 (92.6%) | 6,202 (98.0%) | 5,839 (96.3%) | 2,803 (94.8%) | 3,382 (96.7%) | 31,915 (96.3%) |
| Domain 2: Practice | ||||||||||
| Practice type (percent) | ||||||||||
| Academic health center | 426 (8.7%) | 106 (7.0%) | 292 (9.7%) | 186 (7.3%) | 101 (7.4%) | 351 (5.9%) | 405 (7.1%) | 226 (8.2%) | 280 (8.3%) | 2,373 (7.6%) |
| Federally qualified health center | 254 (5.2%) | 64 (4.2%) | 211 (7.0%) | 221 (8.7%) | 201 (14.6%) | 590 (9.8%) | 271 (4.8%) | 91 (3.3%) | 124 (3.7%) | 2,027 (6.5%) |
| Federal military | 86 (1.8%) | 83 (5.5%) | 69 (2.3%) | 112 (4.4%) | 24 (1.7%) | 223 (3.7%) | 411 (7.2%) | 83 (3.0%) | 174 (5.2%) | 1,265 (4.1%) |
| Rural health center | 123 (2.5%) | 57 (3.8%) | 19 (0.6%) | 82 (3.2%) | 28 (2.0%) | 101 (1.7%) | 61 (1.1%) | 148 (5.4%) | 97 (2.9%) | 716 (2.3%) |
| Independently owned | 1,231 (25.2%) | 596 (39.4%) | 993 (32.8%) | 829 (32.6%) | 329 (23.9%) | 1,418 (23.7%) | 1,987 (35.0%) | 606 (22.0%) | 1,295 (38.4%) | 9,284 (29.8%) |
| Managed care/HMO | 83 (1.7%) | 8 (0.5%) | 23 (0.8%) | 139 (5.5%) | 14 (1.0%) | 1,239 (20.7%) | 278 (4.9%) | 64 (2.3%) | 81 (2.4%) | 1,929 (6.2%) |
| Hospital/Health system | 2,354 (48.2%) | 470 (31.1%) | 1,189 (39.3%) | 699 (27.5%) | 582 (42.4%) | 1,363 (22.7%) | 1,734 (30.5%) | 1,369 (49.6%) | 964 (28.6%) | 10,724 (34.4%) |
| Other | 324 (6.6%) | 128 (8.5%) | 228 (7.5%) | 276 (10.8%) | 95 (6.9%) | 710 (11.8%) | 529 (9.3%) | 172 (6.2%) | 356 (10.6%) | 2,818 (9.1%) |
| Principal practice ownership (percent) | ||||||||||
| Not owner | 3,807 (78.0%) | 970 (64.2%) | 2,249 (74.4%) | 1,809 (71.1%) | 1,113 (81.0%) | 3,766 (62.8%) | 4,064 (71.6%) | 2,202 (79.8%) | 2,266 (67.2%) | 22,246 (71.4%) |
| Owner | 1,074 (22.0%) | 542 (35.8%) | 775 (25.6%) | 735 (28.9%) | 261 (19.0%) | 2,229 (37.2%) | 1,612 (28.4%) | 557 (20.2%) | 1,105 (32.8%) | 8,890 (28.6%) |
| Practice size (percent) | ||||||||||
| Group | 4,369 (89.5%) | 1,296 (85.7%) | 2,601 (86.0%) | 2,341 (92.0%) | 1,263 (91.9%) | 5,480 (91.4%) | 4,923 (86.7%) | 2,614 (94.7%) | 2,804 (83.2%) | 27,691 (88.9%) |
| Solo | 512 (10.5%) | 216 (14.3%) | 423 (14.0%) | 203 (8.0%) | 111 (8.1%) | 515 (8.6%) | 753 (13.3%) | 145 (5.3%) | 567 (16.8%) | 3,445 (11.1%) |
| Practice specialty mix (percent) | ||||||||||
| Family medicine only | 2,488 (54.3%) | 790 (55.9%) | 1,590 (56.8%) | 1,162 (49.4%) | 621 (49.7%) | 1,914 (34.6%) | 2,774 (53.1%) | 1,344 (52.1%) | 1,623 (51.5%) | 14,306 (49.5%) |
| Multiple specialties (Not only primary care) | 958 (20.9%) | 245 (17.3%) | 486 (17.4%) | 505 (21.5%) | 222 (17.8%) | 1,728 (31.2%) | 931 (17.8%) | 690 (26.7%) | 643 (20.4%) | 6,408 (22.2%) |
| Primary care specialty mix | 1,136 (24.8%) | 379 (26.8%) | 721 (25.8%) | 684 (29.1%) | 406 (32.5%) | 1,888 (34.1%) | 1,522 (29.1%) | 546 (21.2%) | 883 (28.0%) | 8,165 (28.3%) |
| Health care professional collaboration in practice | ||||||||||
| Physician assistant | 2,183 (38.1%) | 629 (32.8%) | 1,575 (45.4%) | 1,769 (59.6%) | 786 (49.6%) | 3,645 (53.2%) | 3,139 (46.2%) | 1,907 (57.3%) | 1,588 (38.6%) | 17,221 (46.8%) |
| Domain 3: Community | ||||||||||
| Social deprivation index (SD) | 41.88 (28.14) | 53.47 (22.74) | 38.71 (29.35) | 44.58 (26.76) | 31.01 (24.59) | 58.82 (24.23) | 49.09 (27.09) | 27.51 (20.89) | 59.81 (25.15) | 47.11 (27.83) |
| Rurality (percent) | ||||||||||
| Isolated | 147 (2.6%) | 52 (2.7%) | 49 (1.4%) | 91 (3.1%) | 100 (6.3%) | 73 (1.1%) | 88 (1.3%) | 180 (5.4%) | 47 (1.1%) | 827 (2.3%) |
| Small rural | 414 (7.2%) | 180 (9.4%) | 89 (2.6%) | 193 (6.5%) | 103 (6.5%) | 152 (2.2%) | 162 (2.4%) | 396 (11.9%) | 210 (5.1%) | 1,899 (5.2%) |
| Large rural | 567 (9.9%) | 317 (16.6%) | 192 (5.5%) | 295 (10.0%) | 147 (9.3%) | 337 (4.9%) | 424 (6.2%) | 518 (15.6%) | 313 (7.6%) | 3,110 (8.5%) |
| Urban | 4,591 (80.3%) | 1,364 (71.3%) | 3,130 (90.5%) | 2,381 (80.4%) | 1,231 (77.9%) | 6,280 (91.8%) | 6,111 (90.1%) | 2,228 (67.1%) | 3,536 (86.1%) | 30,852 (84.1%) |
| Premature death rate (percent) | ||||||||||
| High | 138 (2.5%) | 479 (26.2%) | 18 (0.5%) | 117 (4.0%) | 10 (0.6%) | 37 (0.6%) | 649 (9.9%) | 89 (2.7%) | 315 (7.9%) | 1,852 (5.2%) |
| Medium | 2,805 (49.9%) | 1,145 (62.6%) | 1,353 (40.5%) | 631 (21.8%) | 385 (25.0%) | 515 (7.7%) | 2,627 (40.0%) | 1,174 (35.9%) | 1,368 (34.3%) | 12,003 (33.6%) |
| Low | 2,676 (47.6%) | 206 (11.3%) | 1,968 (58.9%) | 2,151 (74.2%) | 1,146 (74.4%) | 6,139 (91.8%) | 3,288 (50.1%) | 2,005 (61.4%) | 2,309 (57.8%) | 21,888 (61.2%) |
| Domain 4: Healthcare market | ||||||||||
| Beds per hospital (percent) | ||||||||||
| High | 3,651 (65.0%) | 1,175 (64.2%) | 2,819 (84.4%) | 1,891 (65.2%) | 1,035 (67.2%) | 5,571 (83.2%) | 5,073 (77.3%) | 1,766 (54.0%) | 2,834 (71.0%) | 25,815 (72.2%) |
| Medium | 1,670 (29.7%) | 555 (30.3%) | 435 (13.0%) | 874 (30.1%) | 487 (31.6%) | 1,035 (15.5%) | 1,138 (17.3%) | 1,152 (35.3%) | 932 (23.3%) | 8,278 (23.2%) |
| Low | 298 (5.3%) | 100 (5.5%) | 85 (2.5%) | 134 (4.6%) | 19 (1.2%) | 88 (1.3%) | 353 (5.4%) | 350 (10.7%) | 226 (5.7%) | 1,653 (4.6%) |
| Medicare cost per capita (percent) | ||||||||||
| High | 1,440 (25.6%) | 316 (17.3%) | 1,438 (43.1%) | 220 (7.6%) | 756 (49.1%) | 3,847 (57.5%) | 2,000 (30.5%) | 365 (11.2%) | 2,443 (61.2%) | 12,825 (35.9%) |
| Medium | 3,173 (56.5%) | 1,280 (69.9%) | 1,540 (46.1%) | 1,339 (46.2%) | 449 (29.1%) | 1,430 (21.4%) | 3,797 (57.8%) | 2,074 (63.5%) | 1,468 (36.8%) | 16,550 (46.3%) |
| Low | 1,006 (17.9%) | 234 (12.8%) | 361 (10.8%) | 1,340 (46.2%) | 336 (21.8%) | 1,417 (21.2%) | 767 (11.7%) | 829 (25.4%) | 81 (2.0%) | 6,371 (17.8%) |
| External reasons for not practicing OB or Inpatient Medicine (percent) | ||||||||||
| No | 3,906 (68.2%) | 1,290 (67.4%) | 2,158 (62.2%) | 1,870 (63.0%) | 952 (60.1%) | 4,136 (60.4%) | 4,121 (60.6%) | 2,292 (68.8%) | 2,720 (66.1%) | 23,445 (63.8%) |
| Yes | 1,823 (31.8%) | 625 (32.6%) | 1,310 (37.8%) | 1,096 (37.0%) | 633 (39.9%) | 2,717 (39.6%) | 2,679 (39.4%) | 1,039 (31.2%) | 1,396 (33.9%) | 13,318 (36.2%) |
*All tests have P-values of < 0.0001.
Abbreviation: SD, Standard deviation.