title: Solo and Small Practices: A Vital, Diverse Part of Primary Care.
abstract: OBJECTIVE
  Solo and small practices are facing growing pressure to consolidate. Our objectives were to determine (1) the percentage of family physicians in solo and small practices, and (2) the characteristics of and services provided by these practices.
  
  
  METHODS
  A total of 10,888 family physicians seeking certification through the American Board of Family Medicine in 2013 completed a demographic survey. Their practices were split into categories by size: solo, small (2 to 5 providers), medium (6 to 20 providers), and large (more than 20 providers). We also determined the rurality of the county where the physicians practiced. We developed 2 logistic regression models: one assessed predictors of practicing in a solo or small practice, while the other was restricted to solo and small practices and assessed predictors of practicing in a solo practice.
  
  
  RESULTS
  More than one-half of respondents worked in solo or small practices. Small practices were the largest group (36%) and were the most likely to be located in a rural setting (20%). The likelihood of having a care coordinator and medical home certification increased with practice size. Physicians were more likely to be practicing in small or solo practices (vs medium-sized or large ones) if they were African American or Hispanic, had been working for more than 30 years, and worked in rural areas. Physicians were more likely to be practicing in small practices (vs solo ones) if they worked in highly rural areas.
  
  
  CONCLUSIONS
  Family physicians in solo and small practices comprised the majority among all family physicians seeking board certification and were more likely to work in rural geographies. Extension programs and community health teams have the potential to support transformation within these practices.
authors.affiliation: Virginia Commonwealth University, Richmond, Virginia winstonrliaw@gmail.com.
authors.forename: Winston R
authors.initials: WR
authors.lastname: Liaw
authors.affiliation: Robert Graham Center, Washington, DC.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Jetty
authors.affiliation: Robert Graham Center, Washington, DC.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Petterson
authors.affiliation: American Board of Family Medicine, Lexington, Kentucky.
authors.forename: Lars E
authors.initials: LE
authors.lastname: Peterson
authors.affiliation: Robert Graham Center, Washington, DC.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Bazemore
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D002568:Certification; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006123:Group Practice / Q000458:organization & administration / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration*; D011331:Private Practice / Q000458:organization & administration* / Q000706:statistics & numerical data; D017009:Professional Autonomy; D019035:Rural Health Services / Q000458:organization & administration; D014481:United States
keywords: physician’s practice patterns; practice-based research; primary care; private practice; rural health services; solo practice