title: Private practice rates among pediatric subspecialists.
abstract: OBJECTIVE
  Historically, most pediatric subspecialists have conducted their clinical work in academic health centers. However, increases in the absolute numbers of pediatric subspecialists in past decades, combined with greater concentrations of children in urban and suburban settings, might result in more opportunities for pediatric subspecialists to enter private practice. Our goal was to assess the proportions of subspecialists in private practice.
  
  
  METHODS
  We surveyed a stratified, random, national sample of 1696 subspecialists from 5 subspecialties and assessed the ownership of their current clinical practice settings.
  
  
  RESULTS
  The response rate was 77%. Two-thirds of respondents (65% [n = 705]) reported that they work in academic hospitals or outpatient clinics. Compared with other subspecialists, greater proportions of neonatologists (38% [n = 92]) and critical care physicians (19% [n = 44]) reported that they work in community hospitals. Larger proportions of cardiologists (27% [n = 58]) and gastroenterologists (24% [n = 47]) reported that they work in private outpatient practices.
  
  
  CONCLUSIONS
  There were significant proportions of pediatric subspecialists in private practice in most of the 5 subspecialties studied. Ensuring children's access to pediatric subspecialists likely will require a robust workforce in both academic and private clinical settings. Ongoing studies of the career trajectories of pediatric subspecialists with respect to their venues of practice will be essential for future workforce planning.
authors.affiliation: Child Health Evaluation and Research Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, School of Medicin, University of Michigan, Ann Arbor, Michigan 48109-0456, USA. gfreed@med.umich.edu
authors.forename: Gary L
authors.initials: GL
authors.lastname: Freed
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Dunham
authors.forename: Carol
authors.initials: C
authors.lastname: Loveland-Cherry
authors.forename: Kristy K
authors.initials: KK
authors.lastname: Martyn
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Moote
mesh_terms: D000328:Adult; D002309:Cardiology / Q000706:statistics & numerical data; D004635:Emergency Medicine / Q000706:statistics & numerical data; D005260:Female; D005762:Gastroenterology / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006405:Hematology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data; D008875:Middle Aged; D009359:Neonatology / Q000706:statistics & numerical data; D010372:Pediatrics / Q000706:statistics & numerical data*; D011331:Private Practice / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States