The Changing Structure of Medical Group Practice in the United States, 1969 to 1980

Abstract

During the 20th century, the organizational structure of physicians' practice in the United States has undergone major transformation. Prior to World War II, physicians were predominantly solo practitioners. Many who were located in rural areas had little or no professional contact with colleagues. Since 1950, however, group practice has emerged as a major form of physician organization and has in recent years shown increasingly rapid growth. Interest in group practice has also been heightened by its relationship to many new forms of prepaid care delivery, including several types of health maintenance organizations. In addition, research on such topics as physician productivity and health care cost containment has examined closely the effects of group practice formation. For these reasons, it is important to monitor the growth and development of group practice as both a cause and effect of changes in the market for physician services. In discussing the evolution of medical