Almost 75 percent of physicians accepted all or most new Medicare patients last year, according to the Center for Studying Health System Change (HSC) 2008 Health Tracking Physician Survey.
The survey indicates most physicians contracted with managed care plans, while slightly fewer than six in 10 physicians provided charity care in 2008.
"Physicians' clinical decisions affect how up to 90 percent of every healthcare 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 healthcare reform in 15 years," said HSC President Paul B. Ginsburg.
Funded by the Robert Wood Johnson Foundation, the 2008 Health Tracking Physician Survey covers a 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 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.
Findings are detailed in "A Snapshot of U.S. Physicians: Key Findings from the 2008 Health Tracking Physician Survey."
- 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 percent) were 40-55 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. Also, 56 percent 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 – such as an adjustment based on 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.
- Fifty-three percent reported their practices were accepting all or most new Medicaid patients, while 28 percent reported accepting no new Medicaid patients. Eighty-seven percent reported their practices were accepting all or most new privately insured patients, and 74 percent reported their practices accept all or most new Medicare patients.
- Eighty-seven percent 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, 59 percent of U.S. physicians reported providing charity care – defined as free or reduced-cost care – to 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.
- 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.