The portion of US physicians who practice primary care has been declining, and there is general agreement that the United States has a shortage of primary care physicians. In spite of this shortage, both the number of first-year residency positions in family practice residencies1,2 and the match rate for the existing family practice first-year residency positions have declined.3 In the past, ru...

KEY FINDINGS From 1998 to 2008, the proportion of physician office-based visits in the United States became increasingly concentrated on those aged 45 and over. The intensity of physician office visits, as measured by medications prescribed or continued, imaging tests ordered or provided, and time spent with physicians, also became increasingly concentrated on those aged 45 and over. Although m...

PURPOSE Our objective was to assess and categorize harm occurring to patients who called their physicians' office after-hours but did not have their call forwarded to the physician because they stated that their call was not an emergency. METHODS We collected data on 4949 calls handled by our answering service for 1 year in a family medicine residency office in Denver, CO. Of the 2835 after-h...

In this new scheme, entities may purchase individual insurance policies on separate medical products and services. We will explore how this may be implemented in clinical scenarios. Also, we will explore how this scheme may promote favorable clinical and economic outcomes. With this proposed scheme, instead of one insurance policy, an individual could select single policies on only those produc...

OBJECTIVE To explore how primary care physicians respond to a community's needs and challenges. DESIGN Qualitative study using focus groups. SETTING Fee-for-service practices or community health centres in downtown Toronto, Ont. PARTICIPANTS Purposive sample of 21 community family physicians (10 women and 11 men). METHOD Participants were invited to join focus groups of four to six phys...

BACKGROUND Japan's stagnant economy has produced increasing income disparities, and the effect of poverty on health and health-care utilization is a significant issue. Co-payments could be a trade-off for patients when seeking medical care and limit health-care utilization. We sought primary care physicians' experiences in dealing with financially deprived patients and their perspectives about ...

BACKGROUND The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team...

BACKGROUND Questions about the existence of supplier-induced demand emerge repeatedly in discussions about governing Swiss health care. This study therefore aimed to evaluate the interrelationship between structural factors of supply and the volume of services that are provided by primary care physicians in Switzerland. METHODS The study was designed as a cross-sectional investigation, based ...