Physician practice style patterns with established patients: Determinants and differences between family practice and general internal medicine residents

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Abstract

Background and Objectives: This paper examines the practice style patterns of family practice and internal medicine residents for established patient visits. Methods: New adult patients (n=509) were prospectively and randomly assigned to family practice or internal medicine clinics at a university medical center and followed for I year of care by resident physicians. Initial and return visits were videotaped, and physician practice styles were analyzed using the Davis Observation Code (DOC). Results: Resident physicians' practice styles with established patients during return visits were associated with various factors, depending on the DOC cluster of behaviors studied. These factors include patient gender, age, income, physical and mental health status, level of pain, number of return visits, and physician practice style displayed during the initial encounter. Family practice return visits had a greater emphasis on preventive services and counseling, compared with internal medicine return visits. Internists spent more visit time using technically oriented behaviors. Conclusions: Patient variables, as well as baseline physician behavior, have an important influence on physician practice styles during return patient visits. There are measurable differences in the established practice styles between family practice and internal medicine resident physicians, which may reflect differences in professional training programs.

Original languageEnglish (US)
Pages (from-to)187-194
Number of pages8
JournalFamily Medicine
Volume31
Issue number3
StatePublished - Mar 1999

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Physicians' Practice Patterns
Family Practice
Internal Medicine
Physicians
Observation
Health Status
Counseling
Mental Health
Education
Pain

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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title = "Physician practice style patterns with established patients: Determinants and differences between family practice and general internal medicine residents",
abstract = "Background and Objectives: This paper examines the practice style patterns of family practice and internal medicine residents for established patient visits. Methods: New adult patients (n=509) were prospectively and randomly assigned to family practice or internal medicine clinics at a university medical center and followed for I year of care by resident physicians. Initial and return visits were videotaped, and physician practice styles were analyzed using the Davis Observation Code (DOC). Results: Resident physicians' practice styles with established patients during return visits were associated with various factors, depending on the DOC cluster of behaviors studied. These factors include patient gender, age, income, physical and mental health status, level of pain, number of return visits, and physician practice style displayed during the initial encounter. Family practice return visits had a greater emphasis on preventive services and counseling, compared with internal medicine return visits. Internists spent more visit time using technically oriented behaviors. Conclusions: Patient variables, as well as baseline physician behavior, have an important influence on physician practice styles during return patient visits. There are measurable differences in the established practice styles between family practice and internal medicine resident physicians, which may reflect differences in professional training programs.",
author = "Bertakis, {Klea D.} and Robbins, {John A.} and Callahan, {Edward J.} and Helms, {L. Jay} and Rahman Azari",
year = "1999",
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T2 - Determinants and differences between family practice and general internal medicine residents

AU - Bertakis, Klea D.

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AU - Callahan, Edward J.

AU - Helms, L. Jay

AU - Azari, Rahman

PY - 1999/3

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N2 - Background and Objectives: This paper examines the practice style patterns of family practice and internal medicine residents for established patient visits. Methods: New adult patients (n=509) were prospectively and randomly assigned to family practice or internal medicine clinics at a university medical center and followed for I year of care by resident physicians. Initial and return visits were videotaped, and physician practice styles were analyzed using the Davis Observation Code (DOC). Results: Resident physicians' practice styles with established patients during return visits were associated with various factors, depending on the DOC cluster of behaviors studied. These factors include patient gender, age, income, physical and mental health status, level of pain, number of return visits, and physician practice style displayed during the initial encounter. Family practice return visits had a greater emphasis on preventive services and counseling, compared with internal medicine return visits. Internists spent more visit time using technically oriented behaviors. Conclusions: Patient variables, as well as baseline physician behavior, have an important influence on physician practice styles during return patient visits. There are measurable differences in the established practice styles between family practice and internal medicine resident physicians, which may reflect differences in professional training programs.

AB - Background and Objectives: This paper examines the practice style patterns of family practice and internal medicine residents for established patient visits. Methods: New adult patients (n=509) were prospectively and randomly assigned to family practice or internal medicine clinics at a university medical center and followed for I year of care by resident physicians. Initial and return visits were videotaped, and physician practice styles were analyzed using the Davis Observation Code (DOC). Results: Resident physicians' practice styles with established patients during return visits were associated with various factors, depending on the DOC cluster of behaviors studied. These factors include patient gender, age, income, physical and mental health status, level of pain, number of return visits, and physician practice style displayed during the initial encounter. Family practice return visits had a greater emphasis on preventive services and counseling, compared with internal medicine return visits. Internists spent more visit time using technically oriented behaviors. Conclusions: Patient variables, as well as baseline physician behavior, have an important influence on physician practice styles during return patient visits. There are measurable differences in the established practice styles between family practice and internal medicine resident physicians, which may reflect differences in professional training programs.

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