Divisional Variation of Clinician, Practice, Community, and Healthcare Market Characteristics of Early 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) | 15.99 (2.68) | 15.53 (2.91) | 15.22 (2.84) | 17.10 (2.81) | 16.05 (2.76) | 16.23 (2.81) | 15.40 (2.88) | 17.51 (2.56) | 15.43 (3.09) | 16.04 (2.90) |
| Domain 1: Clinician | ||||||||||
| Age Mean (SD) | 34.74 (4.07) | 35.43 (4.67) | 34.92 (4.26) | 35.19 (3.86) | 35.51 (4.43) | 35.68 (3.95) | 35.48 (4.76) | 34.48 (3.97) | 35.38 (4.63) | 35.23 (4.30) |
| Gender (percent) | ||||||||||
| Woman | 860 (54.0%) | 258 (49.1%) | 624 (58.3%) | 506 (51.6%) | 296 (64.9%) | 1,353 (59.7%) | 1,106 (55.7%) | 606 (57.6%) | 681 (52.3%) | 6,290 (56.0%) |
| Race (percent) | ||||||||||
| American Indian or Alaska Native | 8 (0.5%) | 5 (1.0%) | 4 (0.4%) | 12 (1.2%) | 2 (0.5%) | 29 (1.3%) | 14 (0.7%) | 9 (0.9%) | 18 (1.4%) | 101 (0.9%) |
| Asian | 298 (19.3%) | 70 (13.6%) | 317 (30.0%) | 132 (13.7%) | 72 (16.6%) | 700 (31.5%) | 327 (16.7%) | 105 (10.1%) | 295 (23.2%) | 2,316 (21.1%) |
| Black or African American | 92 (5.9%) | 50 (9.7%) | 82 (7.8%) | 17 (1.8%) | 25 (5.8%) | 90 (4.1%) | 288 (14.7%) | 32 (3.1%) | 120 (9.4%) | 796 (7.2%) |
| Native Hawaiian or Pacific Islander | 6 (0.4%) | 0 (0%) | 1 (0.1%) | 4 (0.4%) | 2 (0.5%) | 22 (1.0%) | 10 (0.5%) | 1 (0.1%) | 6 (0.5%) | 52 (0.5%) |
| White | 1,110 (71.7%) | 381 (74.0%) | 610 (57.7%) | 771 (80.1%) | 320 (73.9%) | 1,264 (56.9%) | 1,265 (64.8%) | 875 (84.5%) | 800 (62.9%) | 7,396 (67.3%) |
| Other | 34 (2.2%) | 9 (1.7%) | 43 (4.1%) | 27 (2.8%) | 12 (2.8%) | 116 (5.2%) | 49 (2.5%) | 14 (1.4%) | 32 (2.5%) | 336 (3.1%) |
| Ethnicity (percent) | ||||||||||
| Hispanic or Latino | 60 (3.9%) | 14 (2.7%) | 69 (6.5%) | 84 (8.7%) | 17 (3.9%) | 272 (12.2%) | 213 (10.9%) | 31 (3.0%) | 201 (15.8%) | 961 (8.7%) |
| International medical graduate status (percent) | ||||||||||
| International medical graduate | 507 (31.8%) | 149 (28.4%) | 448 (41.8%) | 194 (19.8%) | 127 (27.9%) | 622 (27.4%) | 726 (36.6%) | 181 (17.2%) | 480 (36.9%) | 3,434 (30.6%) |
| Degree type, MD versus DO (percent) | ||||||||||
| DO degree | 323 (20.3%) | 109 (20.8%) | 220 (20.5%) | 221 (22.5%) | 73 (16.0%) | 486 (21.4%) | 330 (16.6%) | 277 (26.3%) | 205 (15.7%) | 2,244 (20.0%) |
| Residency location (percent) | ||||||||||
| Small rural | 1 (0.1%) | 12 (2.4%) | 2 (0.2%) | 0 (0%) | 1 (0.2%) | 4 (0.2%) | 2 (0.1%) | 0 (0%) | 11 (1.0%) | 33 (0.3%) |
| Large rural | 65 (4.4%) | 55 (11.0%) | 21 (2.0%) | 22 (2.4%) | 30 (6.7%) | 64 (3.0%) | 80 (4.4%) | 48 (4.8%) | 38 (3.3%) | 423 (4.0%) |
| Urban | 1,419 (95.6%) | 431 (86.5%) | 1,020 (97.8%) | 879 (97.6%) | 416 (93.1%) | 2,097 (96.9%) | 1,755 (95.5%) | 952 (95.2%) | 1,099 (95.7%) | 10,068 (95.7%) |
| Domain 2: Practice | ||||||||||
| Practice type (percent) | ||||||||||
| Academic health center | 230 (16.7%) | 42 (10.1%) | 148 (17.1%) | 88 (10.4%) | 57 (14.5%) | 182 (9.1%) | 207 (13.1%) | 91 (9.9%) | 128 (12.4%) | 1,173 (12.4%) |
| Federally qualified health center | 130 (9.4%) | 43 (10.3%) | 120 (13.8%) | 144 (17.0%) | 96 (24.5%) | 373 (18.7%) | 151 (9.6%) | 45 (4.9%) | 73 (7.0%) | 1,175 (12.5%) |
| Federal military | 14 (1.0%) | 29 (7.0%) | 16 (1.8%) | 51 (6.0%) | 7 (1.8%) | 108 (5.4%) | 155 (9.8%) | 23 (2.5%) | 57 (5.5%) | 460 (4.9%) |
| Rural health center | 50 (3.6%) | 28 (6.7%) | 10 (1.2%) | 54 (6.4%) | 5 (1.3%) | 73 (3.7%) | 37 (2.3%) | 120 (13.0%) | 60 (5.8%) | 437 (4.6%) |
| Independently owned | 133 (9.7%) | 83 (19.9%) | 128 (14.7%) | 119 (14.0%) | 36 (9.2%) | 192 (9.6%) | 243 (15.4%) | 104 (11.3%) | 193 (18.6%) | 1,231 (13.1%) |
| Managed care/HMO | 32 (2.3%) | 8 (1.9%) | 15 (1.7%) | 50 (5.9%) | 12 (3.1%) | 364 (18.2%) | 128 (8.1%) | 10 (1.1%) | 39 (3.8%) | 658 (7.0%) |
| Hospital/Health system | 732 (53.2%) | 163 (39.1%) | 394 (45.4%) | 277 (32.7%) | 165 (42.1%) | 524 (26.2%) | 570 (36.2%) | 482 (52.3%) | 408 (39.4%) | 3,715 (39.4%) |
| Other | 56 (4.1%) | 21 (5.0%) | 37 (4.3%) | 65 (7.7%) | 14 (3.6%) | 181 (9.1%) | 85 (5.4%) | 46 (5.0%) | 78 (7.5%) | 583 (6.2%) |
| Principal practice ownership (percent) | ||||||||||
| Not owner | 1,042 (92.5%) | 240 (81.1%) | 636 (92.8%) | 459 (86.0%) | 258 (95.6%) | 962 (76.2%) | 1,000 (87.1%) | 608 (88.5%) | 671 (87.4%) | 5,876 (86.7%) |
| Owner | 85 (7.5%) | 56 (18.9%) | 49 (7.2%) | 75 (14.0%) | 12 (4.4%) | 300 (23.8%) | 148 (12.9%) | 79 (11.5%) | 97 (12.6%) | 901 (13.3%) |
| Practice size (percent) | ||||||||||
| Group | 1,335 (96.9%) | 393 (94.2%) | 834 (96.1%) | 830 (97.9%) | 387 (98.7%) | 1,964 (98.3%) | 1,518 (96.3%) | 906 (98.4%) | 978 (94.4%) | 9,145 (97.0%) |
| Solo | 42 (3.1%) | 24 (5.8%) | 34 (3.9%) | 18 (2.1%) | 5 (1.3%) | 33 (1.7%) | 58 (3.7%) | 15 (1.6%) | 58 (5.6%) | 287 (3.0%) |
| Practice specialty mix (percent) | ||||||||||
| Family medicine only | 690 (50.1%) | 197 (47.2%) | 411 (47.4%) | 378 (44.6%) | 159 (40.6%) | 566 (28.3%) | 741 (47.0%) | 475 (51.6%) | 434 (41.9%) | 4,051 (42.9%) |
| Multiple specialties (Not only primary care) | 321 (23.3%) | 88 (21.1%) | 195 (22.5%) | 182 (21.5%) | 81 (20.7%) | 577 (28.9%) | 316 (20.1%) | 219 (23.8%) | 266 (25.7%) | 2,245 (23.8%) |
| Primary care specialty mix | 366 (26.6%) | 132 (31.7%) | 262 (30.2%) | 288 (34.0%) | 152 (38.8%) | 854 (42.8%) | 519 (32.9%) | 227 (24.6%) | 337 (32.5%) | 3,137 (33.3%) |
| Domain 3: Community | ||||||||||
| Social deprivation index (SD) | 46.13 (28.70) | 56.67 (22.49) | 43.16 (30.91) | 47.76 (26.57) | 35.46 (27.24) | 60.48 (24.61) | 52.60 (26.94) | 27.73 (21.56) | 59.51 (24.74) | 49.91 (28.04) |
| Rurality (percent) | ||||||||||
| Isolated | 25 (1.6%) | 16 (3.1%) | 13 (1.2%) | 33 (3.4%) | 15 (3.3%) | 29 (1.3%) | 24 (1.2%) | 77 (7.3%) | 11 (0.8%) | 243 (2.2%) |
| Small rural | 142 (9.0%) | 77 (14.8%) | 57 (5.3%) | 97 (9.9%) | 39 (8.6%) | 144 (6.4%) | 124 (6.3%) | 187 (17.8%) | 118 (9.1%) | 985 (8.8%) |
| Large rural | 93 (5.9%) | 59 (11.3%) | 16 (1.5%) | 87 (8.9%) | 31 (6.8%) | 83 (3.7%) | 43 (2.2%) | 160 (15.2%) | 80 (6.2%) | 652 (5.8%) |
| Urban | 1,323 (83.6%) | 370 (70.9%) | 980 (91.9%) | 758 (77.7%) | 370 (81.3%) | 2,003 (88.7%) | 1,790 (90.4%) | 626 (59.6%) | 1,090 (83.9%) | 9,310 (83.2%) |
| Premature death rate (percent) | ||||||||||
| High | 22 (1.4%) | 129 (24.9%) | 2 (0.2%) | 52 (5.3%) | 0 (0%) | 9 (0.4%) | 204 (10.3%) | 27 (2.6%) | 96 (7.4%) | 541 (4.8%) |
| Medium | 787 (49.6%) | 348 (67.1%) | 469 (44.0%) | 234 (24.0%) | 96 (21.1%) | 219 (9.7%) | 785 (39.6%) | 454 (43.2%) | 488 (37.5%) | 3,880 (34.7%) |
| Low | 778 (49.0%) | 42 (8.1%) | 595 (55.8%) | 690 (70.7%) | 360 (78.9%) | 2,028 (89.9%) | 991 (50.1%) | 570 (54.2%) | 716 (55.1%) | 6,770 (60.5%) |
| Domain 4: Healthcare market | ||||||||||
| Beds per hospital (percent) | ||||||||||
| High | 1,128 (71.1%) | 332 (64.0%) | 919 (86.2%) | 618 (63.3%) | 353 (77.4%) | 1,859 (82.3%) | 1,550 (78.3%) | 517 (49.2%) | 881 (67.8%) | 8,157 (72.9%) |
| Medium | 387 (24.4%) | 159 (30.6%) | 123 (11.5%) | 298 (30.5%) | 99 (21.7%) | 361 (16.0%) | 336 (17.0%) | 392 (37.3%) | 323 (24.8%) | 2,478 (22.1%) |
| Low | 72 (4.5%) | 28 (5.4%) | 24 (2.3%) | 60 (6.1%) | 4 (0.9%) | 39 (1.7%) | 94 (4.7%) | 142 (13.5%) | 96 (7.4%) | 559 (5.0%) |
| Medicare cost per capita (percent) | ||||||||||
| High | 461 (29.0%) | 113 (21.8%) | 507 (47.6%) | 83 (8.5%) | 246 (53.9%) | 1,305 (57.8%) | 664 (33.5%) | 164 (15.6%) | 748 (57.5%) | 4,291 (38.3%) |
| Medium | 864 (54.4%) | 357 (68.8%) | 443 (41.6%) | 459 (47.0%) | 130 (28.5%) | 448 (19.8%) | 1,098 (55.5%) | 619 (58.9%) | 521 (40.1%) | 4,939 (44.1%) |
| Low | 262 (16.5%) | 49 (9.4%) | 116 (10.9%) | 434 (44.5%) | 80 (17.5%) | 506 (22.4%) | 218 (11.0%) | 268 (25.5%) | 31 (2.4%) | 1,964 (17.5%) |
| External reasons for not practicing OB or inpatient medicine (percent) | ||||||||||
| No | 1,204 (75.6%) | 368 (70.1%) | 712 (66.5%) | 684 (69.7%) | 311 (68.2%) | 1,546 (68.2%) | 1,265 (63.7%) | 790 (75.1%) | 893 (68.6%) | 7,773 (69.2%) |
| Yes | 388 (24.4%) | 157 (29.9%) | 359 (33.5%) | 297 (30.3%) | 145 (31.8%) | 720 (31.8%) | 721 (36.3%) | 262 (24.9%) | 409 (31.4%) | 3,458 (30.8%) |
| Ratio of primary care physicians | ||||||||||
| High | 50 (3.2%) | 47 (9.1%) | 0 (0%) | 43 (4.4%) | 0 (0%) | 34 (1.5%) | 39 (2.0%) | 162 (15.4%) | 69 (5.3%) | 444 (4.0%) |
| Medium | 517 (32.6%) | 212 (40.8%) | 242 (22.7%) | 326 (33.4%) | 120 (26.3%) | 743 (32.9%) | 595 (30.1%) | 492 (46.8%) | 559 (43.0%) | 3,806 (34.0%) |
| Low | 1,020 (64.3%) | 260 (50.1%) | 824 (77.3%) | 607 (62.2%) | 336 (73.7%) | 1,482 (65.6%) | 1,346 (68.0%) | 397 (37.8%) | 672 (51.7%) | 6,944 (62.0%) |
*External reasons for not practicing OB and Internal Medicine includes selecting either “challenges with privileging” or “not available in the practice I joined”, as reasons for not practicing either inpatient medicine or obstetric care.
±All tests have P-values of < 0.0001.
Abbreviation: SD, Standard deviation.