The impact of physician practice style on medical charges

J Fam Pract. 1999 Jan;48(1):31-6.


Background: There are differences in styles of care among primary care physicians. The purpose of our study was to determine whether differences in physician practice styles and patient health status generate different medical charges.

Methods: New adult patients (N = 509) were randomized to primary care physicians, and use of medical care services and associated charges were monitored for 1 year.

Results: Controlling for baseline patient health status, a technically oriented style of care was associated with significantly higher specialty care, emergency department, diagnostic, and total charges. Some practice behaviors, however, were associated with lower charges; for example, a practice style emphasizing patient activation was associated with significantly lower primary care charges. Both a lower baseline patient health status and a health status that declined over the study period predicted higher charges.

Conclusions: Measurable differences in practice style are associated with differing medical care charges. Patients' health status was also an important determinant of medical charges and had implications for the assessment of physician utilization patterns.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • California
  • Family Practice / economics*
  • Fees, Medical*
  • Female
  • Health Care Costs
  • Health Status
  • Humans
  • Internal Medicine / economics
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / classification
  • Practice Patterns, Physicians' / economics*