An Analysis of the Impact of Gender on Physician Practice Patterns

Asian-Indian physicians' experience with managed care organizations

PURPOSE

There is anecdotal evidence that ethnic minority physicians are underrepresented in managed care contracts. The purpose of this paper, therefore, is to determine ethnic Asian-Indian physician-managed care organization experience and job satisfaction in the USA by age, gender, region and percent of patients in managed care organizations. DESIGN/METHODOLOGY/VALUE: A random (nation-wide) mail survey was conducted of 254 physicians who were American Association of Physicians of Indian Origin (AAPI) members during the period 1998 to 2000. Managed care experience was categorized into physician satisfaction; service quality rating; service limitations; difficulties acquiring and maintaining managed care contracts; and financial impact.

FINDINGS

Physicians in solo and group practice relied heavily on managed care enrolled patients. Limitations providing care to patients was a more serious problem than for those in staff-model health maintenance organization and hospital/clinic-based practices. Physician satisfaction was not significantly related to board certification, practice type, region and managed care participation. However, practice staff participating in managed care had the highest number of board-certified physicians.

RESEARCH LIMITATIONS/IMPLICATIONS

There was a low response rate (37 percent) to data collection using questionnaires.

PRACTICAL IMPLICATIONS

The paper underlines ethnic minority physicians' capability to get managed care contracts.

ORIGINALITY/VALUE

This is the first national study of Asian-Indian physicians and their managed care organization experience. Asian-Indian physicians are over-represented in the medical profession and hence the paper will interest those working and dealing with managed care organizations and their patients.

It's about time: physicians' perceptions of time constraints in primary care medical practice in three national healthcare systems

BACKGROUND

As physicians are pressured to deliver an increasing number of preventive services, follow guidelines, engage in evidence-based practice, and deliver patient-centered care in managerially driven organizations, they struggle with how much control they have over their time.

METHODS

A secondary analysis was conducted with data from 3 parallel studies of clinical decision making in Germany, the United Kingdom, and the United States with 128 physicians per country. Physicians reported how much time they were allocated and how much time they needed for high-quality care for new patient appointments, routine consultations, and complete physicals. They also reported how much control they had over their time in the office and spending adequate time with patients.

RESULTS

German, British, and American physicians were allocated (on average) 16/11/32 minutes for a new patient appointment, 6/10/18 minutes for a routine visit, and 12/20/36 minutes for a complete physical, but felt that they needed more time. Over half of German and American physicians felt that they always or usually had control over the hours they were required to be in their office or spending sufficient time with their patients while less than half of British physicians felt this way.

CONCLUSION

German physicians had the least time allocated and needed for most types of appointment. American physicians had the most time allocated and needed for each type of appointment. However, British physicians felt they had the least control over time in their office and spending sufficient time with patients.