Differences between family physicians' and general internists' medical charges

Med Care. 1999 Jan;37(1):78-82. doi: 10.1097/00005650-199901000-00011.


Objectives: Data from 509 primary care patients were analyzed to determine whether practice style differences between family physicians and general internists generate differential utilization of health care resources leading to differential medical charges.

Methods: New adult patients were prospectively randomized to care by family physicians and general internists. Utilization of medical care services and associated charges then were monitored for 1 year of care.

Results: Family practice patients had a significantly higher mean number of visits to their primary care clinic and significantly fewer emergency room visits than patients assigned to Internal Medicine. Mean charges for primary care and emergency department treatment were significantly lower for patients assigned to Family Practice than for those assigned to General Internal Medicine. There were no significant differences in charges for specialty clinic visits, hospitalizations, or diagnostic services.

Conclusions: Practice style differences between family physicians and general internists were associated with differential medical charges, with family physicians generating lower charges for some aspects of care.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Ambulatory Care / economics
  • Ambulatory Care / statistics & numerical data
  • California
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / statistics & numerical data
  • Family Practice / economics*
  • Fees, Medical / statistics & numerical data*
  • Female
  • Health Services Research
  • Hospitals, University / economics
  • Hospitals, University / statistics & numerical data
  • Humans
  • Internal Medicine / economics*
  • Male
  • Practice Patterns, Physicians' / economics*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Prospective Studies
  • Regression Analysis
  • Utilization Review / economics
  • Utilization Review / statistics & numerical data