FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 302:11-16 January 3, 1980 Number 1 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We analyzed data from the National Ambulatory Medical Care Survey to compare the style of practice of two primary-care providers, general internists and family-general practitioners. Whereas internists spent 18.4 minutes with the average patient, family-general practitioners spent 13.0 minutes. Whereas internists used laboratory tests in 73 per cent of visits and x-ray tests in 53 per cent, family-general practitioners used these studies in 34 and 19 per cent of visits. Internists provided instructions regarding health problems in 17.8 per cent of visits, and family-general practitioners in 12.4 per cent. The two provider groups did not differ in terms of therapy for emotional problems, both providing it in a relatively low proportion of visits (3 per cent). Whether by choice or necessity, family-general practitioners spent less time examining and instructing patients, and they ordered fewer laboratory and x-ray studies. The implications of these differences for the cost and quality of primary care need further study.

This article has been cited by other articles:

• Phillips, R. L., Dodoo, M. S., Green, L. A., Fryer, G. E., Bazemore, A. W., McCoy, K. I., Petterson, S. M. (2009). Usual Source Of Care: An Important Source Of Variation In Health Care Spending. Health Aff (Millwood) 28: 567-577 [Abstract] [Full Text]  
• Paasche-Orlow, M., Roter, D. (2003). The Communication Patterns of Internal Medicine and Family Practice Physicians. J Am Board Fam Med 16: 485-493 [Abstract] [Full Text]  
• Werning, J. W., Preston, T. W., Khuder, S. (2002). Physician Specialty Is Associated With Differences in the Evaluation and Management of Acute Bacterial Rhinosinusitis. Arch Otolaryngol Head Neck Surg 128: 123-130 [Abstract] [Full Text]  
• Stafford, R. S., Blumenthal, D. (1998). Specialty differences in cardiovascular disease prevention practices. J Am Coll Cardiol 32: 1238-1243 [Abstract] [Full Text]  
• McLeod, P. J., Tamblyn, R. M., Gayton, D., Grad, R., Snell, L., Berkson, L., Abrahamowicz, M. (1997). Use of Standardized Patients to Assess Between-Physician Variations in Resource Utilization. JAMA 278: 1164-1168 [Abstract]  
• Dale, J., Lang, H., Roberts, J. A, Green, J., Glucksman, E. (1996). Cost effectiveness of treating primary care patients in accident and emergency: a comparison between general practitioners, senior house officers, and registrars. BMJ 312: 1340-1344 [Abstract] [Full Text]  
• Dale, J., Green, J., Reid, F., Glucksman, E., Higgs, R. (1995). Primary care in the accident and emergency department: II. comparison of general practitioners and hospital doctors. BMJ 311: 427-430 [Abstract] [Full Text]  
• Chernew, M. (1995). HMO Use of Diagnostic Tests: A Review of the Evidence. Med Care Res Rev 52: 196-222 [Abstract]  
• Brand, D. A., Quam, L., Leatherman, S. (1995). Medical Practice Profiling: Concepts and Caveats. Med Care Res Rev 52: 223-251 [Abstract]  
• Chilingerian, J. A., Glavin, M. P. V. (1994). Temporary Firms in Community Hospitals: Elements of a Managerial Theory of Clinical Efficiency. Med Care Res Rev 51: 289-335  
• Myint, S. H. (1994). Common Colds, Asthma and Indoor Air Quality. Indoor and Built Environment 3: 274-277 [Abstract]  
• Franks, P., Nutting, P. A., Clancy, C. M. (1993). Health Care Reform, Primary Care, and the Need for Research. JAMA 270: 1449-1453 [Abstract]  
• Hartz, A., Deber, R., Bartholomew, M., Midtling, J. (1993). Physician Characteristics Affecting Referral Decisions Following an Exercise Tolerance Test. Arch Fam Med 2: 513-519 [Abstract]  
• Kravitz, R. L., Greenfield, S., Rogers, W., Manning, W. G. Jr, Zubkoff, M., Nelson, E. C., Tarlov, A. R., Ware, J. E. Jr (1992). Differences in the Mix of Patients Among Medical Specialties and Systems of Care: Results From the Medical Outcomes Study. JAMA 267: 1617-1623 [Abstract]  
• Greenfield, S., Nelson, E. C., Zubkoff, M., Manning, W., Rogers, W., Kravitz, R. L., Keller, A., Tarlov, A. R., Ware, J. E. Jr (1992). Variations in Resource Utilization Among Medical Specialties and Systems of Care: Results From the Medical Outcomes Study. JAMA 267: 1624-1630 [Abstract]  
• Lipkin, M. Jr., Levinson, W., Barker, R., Kern, D., Burke, W., Noble, J., Wartman, S., Delbanco, T. L. (1990). Primary Care Internal Medicine: A Challenging Career Choice for the 1990s. ANN INTERN MED 112: 371-378 [Abstract]  
• Hainer, B. L., Lawler, F. H. (1988). Comparison of Critical Care Provided by Family Physicians and General Internists. JAMA 260: 354-358 [Abstract]  
• Rich, E. C., Crowson, T. W., Harris, I. B. (1987). The Diagnostic Value of the Medical History: Perceptions of Internal Medicine Physicians. Arch Intern Med 147: 1957-1960 [Abstract]  
• SCHAFFER, W. A., HOLLOMAN, F. C. Jr. (1985). Consultation and Referral Between Physicians in New Medical Practice Environments. ANN INTERN MED 103: 600-605 [Abstract]  
• Rovner, D. R., Rothert, M. L., Holmes, M. M., Ravitch, M. M., Holzman, G. B., Elstein, A. S. (1985). Rationale for Physicians' Decisions to Refer Obese Patients. Med Decis Making 5: 279-292  
• Epstein, A. M., McNeil, B. J. (1985). Physician Characteristics and Organizational Factors Influencing Use of Ambulatory Tests. Med Decis Making 5: 401-415  
• Teitelbaum, M. L. (1982). Toward Better Integration of Medical and Psychiatric Care. JAMA 248: 977-977 [Abstract]  
• Nielsen, A. C. III, Eaton, J. S. Jr (1981). Medical Students' Attitudes About Psychiatry: Implications for Psychiatric Recruitment. Arch Gen Psychiatry 38: 1144-1154 [Abstract]  
• WOOD, R. W., TOMPKINS, R. K., WOLCOTT, B. W. (1980). An Efficient Strategy for Managing Acute Respiratory Illness in Adults. ANN INTERN MED 93: 757-763 [Abstract]