Physician Judgments and Resource Utilization in a Private Practice

A study of 419 visits to a group of internists was conducted in a semirural private practice in upstate New York. The purpose of the study was to obtain physician value judgments about the appropriate level of care for each visit. Each patient visit was judged by a single physician immediately after the physician attended the visit. Judgments about the “complexity of the visit,” the appropriate level of manpower to manage the visit, the urgency of the visit, the number of visits required for management of the problem, the diagnostic classification of the problem, and other variables were judged by a physician for each of the sampled visits. These were supplemented with objective data about the patient. Thirty per cent of the visits were judged to be manageable by a physician expander. These visits were distributed among the short-term episodic illnesses as well as the chronic cases. Finally, the value judgments were used to classify the visits on a scale of “complexity” with focus on the definition of the noncomplex or simple case. Eighty-three per cent of the cases were judged as “relatively cosy to diagnose and treat.”

Family medicine · MEDLINE · Patient care · Private practice · Scale (ratio) · Healthcare Policy and Management · Healthcare Systems and Technology · Medicine · Nursing · Primary Care and Health Outcomes