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Socioeconomic Survey of Pediatricians: Part 1
Pediatricians' Practice and Personal Characteristics

Comparison of Findings From:
PS#43-Part 1 (2000, RR=52%, N=820)
 PS#33 (1996, RR=64%, N=1035)
PS#21 (1993, RR=71%, N=1145)
Table of Contents:
I. Practice Characteristics
II. Personal Characteristics - All Pediatricians
III. Patient Care Activities
IV. Office Management Practices - All Pediatricians
V. Patient Insurance Coverage - All Pediatricians
VI. Experiences with Managed Care (Post-training Pediatricians, in DPC)

I. PRACTICE CHARACTERISTICS OF PEDIATRICIANS
(ALL RESPONDENTS UNLESS OTHERWISE NOTED)
PS#21
(1993)
RR=71%
N=1145
PS#43
(2000)
RR=52%
N=820
Percent of respondents in post graduate training programs:

As a Resident
11.2
11.3

As a Fellow***

8.1
3.9
     

Hours Worked

    

Among Residents:

AVERAGE HOURS PER WEEK IN RESIDENCY TRAINING
73.6
69.8

AVERAGE HOURS PER WEEK IN OTHER PROFESSIONAL ACTIVITIES
6.0
5.2

TOTAL HOURS PER WEEK *

79.6
75.0

Among Fellowship Trainees:

AVERAGE HOURS PER WEEK IN FELLOWSHIP TRAINING
52.3
51.1

AVERAGE HOURS PER WEEK IN OTHER PROFESSIONAL ACTIVITIES
16.4
12.5

TOTAL HOURS PER WEEK
68.7
63.6
 
PS#21
(1993)
PS#43
(2000)
Hours Worked    
Among pediatricians who have completed postgraduate training:

PRACTICE INVOLVING THE DIRECT CARE OF PATIENTS*
(including volunteer work/community service involving DPC and the administration/practice management of own practice)

39.9
41.0

ADMINISTRATION (other than your practice)**
5.2
3.5

MEDICAL TEACHING
4.0
3.5

MEDICAL/HEALTH SERVICES RESEARCH**
2.4
1.5

OTHER MEDICAL ACTIVITIES [including volunteer work community service NOT involving DPC, IRB, credentialing, CME participation, etc.]

2.3
2.5

TOTAL: AVERAGE NUMBER OF HOURS PER WEEK *

53.7
51.9
*p < .05; ** p < .01; ***p < .001
PS#21
(1993)
PS#43
(2000)
Employment Status (percent reporting)

Full-time**
87.9
83.4

Part-time*
8.8
12.1

Temporarily not in practice
1.8
2.7

Semi-retired
.5
.6

Retired
.3
.4

Not active for other reasons
.7
.7
Employment status by sex (percent reporting)
(excludes residents and post-residency training fellows)

Male pediatricians

Part-time
3
4

Full-time
97
96

Female pediatricians

Part-time
24
28

Full-time
76
72
 
100%
100%
Average hours worked per week by employment status and sex (excludes residents and post-residency training fellows)

Part-time:

Male pediatricians
34.2
37.3

Female pediatricians
31.9
31.5

Full-time:

Male pediatricians
58.2
56.8

Female pediatricians
54.3
55.6
 
Primary reason for working 35 hours or less per week***
(percent of pediatricians reporting)

Child care responsibilities
47.7
43.2

Personal preference
22.1
39.2

Sick leave/medical disability
1.2
6.8

Professional society activities
n/a
1.4

Volunteer activities
2.3
-0-

Other
26.7
9.5
*p < .05; ** p < .01; ***p < .001
n/a = not asked
 
PS#21
(1993)
PS#43
(2000)
Practice Area (percent of pediatricians reporting)

Urban, inner-city
27.4
26.7

Urban, not inner-city
31.1
32.1

Suburban
32.3
32.1

Rural
9.2
9.1
PS#21
(1993)
PS#43
(2000)
Employment Settings (average percent of time spent in setting)
Self-employed solo practice*
13.1
9.8
Two-physician practice
6.5
5.5
Pediatric group practice***
18.8
25.8
Multispecialty group*
8.6
11.7
HMO (staff model)*
4.4
2.7
Medical school or parent university**
20.9
15.4
Non-government hospital
10.6
10.7
City/county/state government hospital or clinic**
8.0
4.5
US government hospital or clinic
3.5
2.6
Other (includes free-standing ambulatory care, surgical, or emergency care centers, non-profit community health centers and other patient care and non-patient care settings)***
5.3
11.3
 
100%
100%
Employment Setting
Percent of pediatricians spending >1% time in this setting:
Self-employed solo practice*
14.2
10.6
Two-physician practice
6.9
5.9
Pediatric group practice***
20.0
28.5
Multispecialty group
9.5
12.1
HMO (staff model)*
5.2
3.4
Medical school or parent university***
27.1
19.6
Non-government hospital
14.1
14.8
City/county/state government hospital or clinic**
12.6
8.0
US government hospital or clinic
4.9
3.2
Other (includes free-standing ambulatory care, surgical, or emergency care centers, non-profit community health centers and other patient care and non-patient care settings)***
8.9
16.3
 
Primary Employment Setting: (Percent of pediatricians reporting >50% time in this setting. Excludes residents and post-residency training fellows):
Office-based
63
64
Hospital/clinic-based
17
14
Medical school/university
15
12
Other (includes free-standing ambulatory care, surgical, or emergency care centers, non-profit community health centers and other patient care and non-patient care settings)***
5
11
 
100%
100%
*p < .05; ** p < .01; ***p < .001
 
PS#21
(1993)
PS#43
(2000)
General Pediatrics v. Subspecialty
Average % of time in General Pediatrics**
53.9
61.7
% of pediatricians who spend 100% of their time in General Pediatrics
35.7
42.6
% of pediatricians who spend 100% of their time in a subspeciality area
27.0
23.5
% of pediatricians who spend time in both General Pediatrics and a subspeciality area
37.3
33.9
*p < .05; ** p < .01; ***p < .001

II. PERSONAL CHARACTERISTICS OF PEDIATRICIANS - ALL RESPONDENTS
PS#21
(1993)
PS#43
(2000)
Sex (percent of pediatricians reporting)***
Male
60.2
52.3
Female
39.8
47.8
     
Age    
Mean years*
42.3
43.3
Percent of pediatricians by age group:

<34 years
26.2
24.2

35-44 years
38.0
34.5

45-54 years
21.6
25.3

55-64 years
10.7
11.9

>65 years

3.6
4.2
Racial or cultural group (percent of pediatricians reporting)***
White, non-Hispanic/Latino
81.0
75.3
Asian or Pacific Islander
11.6
15.0
Hispanic/Latino
4.8
5.3
African-American or African Ancestry
1.9
4.5
Native American or Alaskan Native
.7
-0-
Other
n/a
n/a
Racial/cultural group by sex (percent of pediatricians reporting)
White (non-Hispanic/Latino)

Male

76.7

Female
71.5
Non-White

Male
23.2

Female
28.5
Estimated earned income from professional activities, after expenses and before taxes (Percent of pediatricians reporting)***
(1993 dollars)
(1999 dollars)
Less than $50,000
22.3
17.9
$50,000 - 74,999
12.9
7.7
$75,000 - 99,999
19.0
13.1
$100,000 - 124,999
17.2
21.9
$125,000 - 149,999
11.2
13.6
$150,000 - 199,999
8.8
14.2
$200,000 and over
8.7
11.7
 
Mean income in 1999 dollars for both survey years is $100,000 - $124,999
*p < .05; ** p < .01; ***p < .001
n/a = not asked

III. PATIENT CARE ACTIVITIES

 
PS#21
(1993)
RR=71%
N=734
PS#43
(2000)
RR=52%
N=540
Direct patient care (DPC)
92.4
93.9
Percent of DPC pediatricians who provide care in an office or clinic-based setting
86.2
82.9
Percent of ALL pediatricians who provide DPC in an office or clinic-based setting
79.6
77.8
 
The following items apply to pediatricians who have completed their residency or fellowship training and provide direct patient care in office or clinic-based settings
 
PS#21
(1993)
PS#43
(2000)
Average number of hours per week personally spent in (pediatricians reporting):
Office or other ambulatory care setting seeing patients
32.6
32.4
Hospital: making rounds or doing other hospital activity*
6.0
4.8
Record keeping and other office work***
4.8
3.8
Talking with patients/parents or consulting over the telephone***
4.5
3.2
Emergency room**
1.6
0.8
Operating or delivery room
0.9
1.1
Other patient care activities**
1.2
0.5
 
TOTAL hours per week in patient care***
51.1
46.6
*p < .05; ** p < .01; ***p < .001
Average number of patient visits per week
102.5
93.6
Percent of patient visits per week by age group:
Birth to 2 years
40.1
39.8
3 to 5 years
19.7
20.5
6 to 11 years*
19.6
21.3
12 to 17 years**
11.4
14.2
18 years and older**
7.3
4.2
 
Average length (in minutes) of a typical preventive care visit by patient age (includes all care given and services performed by ALL personnel)
Birth to 2 years*.
23.6
22.1
3 to 5 years
22.9
21.9

6 to 11 years
22.2
21.6
12 to 17 years
25.7
24.7
18 years and older
17.2
18.0
 
Reasons for patient visits (reported as a percent of all visits per week)
Well/preventive care visits or services (no problems identified)
35.3
36.9
A clear physical problem requiring workup, treatment, referral or follow-up***
46.2
32.4
A follow-up visit for a specific problem
n/a
15.2
A clear psychosocial problem requiring workup, treatment, referral or follow-up
8.6
7.8
An ambiguous or unclear problem
5.8
5.6
Other
4.0
2.3
 
100%
100%
 
Average number of minutes patients must wait to see the pediatrician after arriving for a scheduled appointment:
n/a
19.5
*p < .05; ** p < .01; ***p < .001
n/a = not asked
The following items apply to pediatricians who have completed their residency or fellowship training and provide direct patient care in office or clinic-based settings

IV. OFFICE MANAGEMENT
 
PS#21
(1993)
RR=71%
N=734
PS#43
(2000)
RR=52%
N=540
Telephone triage provided by main practice during office hours (percent of pediatricians reporting):

Nursing/office staff using written telephone triage protocols
n/a
63.9

Nursing/office staff using no written protocols

46.0

Computerized/automated triage system for incoming calls
7.3

Other
0.8
 
Telephone triage provided by main practice after office hours (percent of pediatricians reporting):

Answering service/hospital switchboard (page MD on call)
n/a
64.0

Centralized triage service with trained staff using written decision protocols

20.6

Centralized triage service with trained staff using computerized protocols

19.3

Voice mail (directions to call 911/ED or leave non-urgent recorded message)

14.0

Centralized triage service with trained staff

11.2

Other (specify)
0.4

V. PATIENTS' INSURANCE COVERAGE
 
PS#21
(1993)
PS#43
(2000)
Percentage of patients covered by health insurance type:
(pediatricians' estimate) #
Private insurance
61.0
62.3
Public insurance
26.9
30.6
Uninsured/self-pay***
11.9
5.9
 
Percent of patients covered by managed care health plans:
(pediatricians' estimate)
Managed care
57.9
58.3
Non-managed care
42.0
34.5
(uninsured/self-pay)
n/a
5.9
 
(# Denominator for PS21 is "insured" patients; for PS43, "all" patients)
 
Percentage of pediatricians who are aware of patients' insurance status during an office visit:
Always/almost always aware
n/a
61.2
Sometimes aware
28.2
Rarely/never aware
10.5
*p < .05; ** p < .01; ***p < .001
n/a = not asked
VI. EXPERIENCES WITH MANAGED CARE

The following items apply to pediatricians who have completed their residency or fellowship training and provide direct patient care in any employment setting, except where noted
 
 
PS#33
(1996)
N=692
PS#43
(2000)
N=676
Percent of pediatricians with patients in managed care
91.3
94.0#
 
Average number of managed care plans pediatricians are currently contracted with to provide patient care
14.6
9.8#
 
Average number of years pediatricians have practiced within one or more managed care health insurance system(s)***
(among pediatricians who have patients in managed care)
5.7
7.0
 
Average number of years pediatricians have participated in their most active managed care contract (ie, the contract with the most patient visits)
(among pediatricians who have patients in managed care)
n/a
6.0
 
Percent of pediatricians who participated in a managed care plan that went out of business due to financial failure***
10.9
30.9
     

Estimated percent of pediatricians' managed care plans (either private or public) that are capitated
(among pediatricians who have patients in managed care)

n/a
38.5
 
Percent of pediatricians reporting payments for referrals are included in all, some or none of their capitated managed care contracts (among pediatricians with capitated managed care plans):
Referrals included in ALL capitated managed care contracts
11.1
7.1
Referrals included in SOME capitated managed care contracts
23.4
20.5
Referrals included in NO managed care contacts
65.5
72.4
 
Estimated percentage of pediatricians' managed care plans (either private or public) that are discounted fee-for-service
(among pediatricians who have patients in managed care)
n/a
61.0
 
Average percentage discount on discounted fee-for-service contracts (among pediatricians with discounted f-f-s contracts)**
21.3
26.3
 
# Percent for PS#43 (2000) is based on pediatricians who have completed their residency or fellowship training and provide direct patient care in office- or clinic-based settings.
*p<.05; **p<.01; ***p<.001
n/a = not asked

 





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