title: Results from using a new dyadic-dependence model to analyze sociocentric physician networks.
abstract: Professional physician networks can potentially influence clinical practices and quality of care. With the current focus on coordinated care, discerning influences of naturally occurring clusters and other forms of dependence among physicians' relationships based on their attributes and care patterns is an important area of research. In this paper, two directed physician networks: a physician influential conversation network (N = 33) and a physician network obtained from patient visit data (N = 135) are analyzed using a new model that accounts for effect modification of the within-dyad effect of reciprocity and inter-dyad effects involving three (or more) actors. The results from this model include more nuanced effects involving reciprocity and triadic dependence than under incumbent models and more flexible control for these effects in the extraction of other network phenomena, including the relationship between similarity of individuals' attributes (e.g., same-gender, same residency location) and tie-status. In both cases we find extensive evidence of clustering and triadic dependence that if not accounted for confounds the effect of reciprocity and attribute homophily. Findings from our analysis suggest alternative conclusions to those from incumbent models.
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA. Electronic address: sudeshna.paul@emory.edu.
authors.forename: Sudeshna
authors.initials: S
authors.lastname: Paul
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA 02115-5899, USA. Electronic address: keating@hcp.med.harvard.edu.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Keating
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA 02115-5899, USA. Electronic address: landon@hcp.med.harvard.edu.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Landon
authors.affiliation: Dartmouth College, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Suite 300, Room 3066, 35 Centerra Parkway, Lebanon, NH 03766, USA. Electronic address: James.OMalley@Dartmouth.edu.
authors.forename: A James
authors.initials: AJ
authors.lastname: O'Malley
mesh_terms: D003142:Communication; D006801:Humans; D007400:Interprofessional Relations; D008962:Models, Theoretical; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D060756:Social Networking
keywords: Dyadic independence; Latent variables; Patient sharing; Physician influence; Sociocentric network; Transitivity