Does the content of primary care visits differ by the racial composition of physicians' practices?
OBJECTIVE
The study compared the content of primary care visits between physicians with larger and smaller African American practices.


METHODS
We compared the content of primary care adult visits between physicians with larger and smaller African American practices using data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey 1997 to 2002. Larger African American practice (>14% of primary care visits by African Americans) was empirically defined to conform with previous studies.


RESULTS
Larger African American practices comprised 24% of all practices but accounted for 80% of all visits by African American patients. In adjusted analyses, physicians with larger African American practices were less likely to refer patients to specialists (adjusted odds ratio 0.77; 95% confidence internal 0.61-0.98) and marginally less likely to perform rectal examinations (adjusted odds ratio 0.84; 95% confidence interval 0.56-1.00) but were more likely to schedule a return appointment (adjusted odds ratio 1.25; 95% confidence interval, 1.02-1.52). However, there were no other significant differences in the reported content of the office visits. Results were not altered when different cutoffs for larger African American practices were used or when obstetricians-gynecologists were excluded from the analyses.


CONCLUSIONS
There are few differences in the content of office visits between physicians with larger and smaller African American practices.
Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. Kevin_Fiscella@urmc.rochester.edu
Kevin
K
Fiscella
Peter
P
Franks
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D016017:Odds Ratio; D009819:Office Visits / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013038:Specialization; D014481:United States