Superspecialization of Medical and Surgical Subspecialists;Final rept

摘要

This project sought to enhance our understanding of the factors that influence physicians' scope of practice - that is, the services they actually provide chosen from among all the services they are trained to perform. The project focused on six medical and surgical subspecialties: cardiology, gastroenterology, pulmonology, orthopedic surgery, ophthalmology, and urology. The conceptual framework for the project was based on the economic theory of specialization as applied to the physician services market, and the data sources included Medicare administrative data and other secondary data files containing information on market characteristics. The analyses of narrowness of practice scope found no consistent pattern of results$ in particular, neither physician characteristics nor market attributes had consistent effects on the narrowness on physicians' scope of practice. The results of the analyses of physician provision of highly specialized services were somewhat more consistent. Nonetheless, there was no consistent effect of market factors on the provision of highly specialized services. The findings of this project suggest that there is a need for developing better measures of practice scope and a better approach to classifying physician services for analyses of physician services markets.