Practice Ownership Research Articles

Owners’ insights into private practice dentistry in New South Wales and the Australian Capital Territory

The aim of this study was to investigate aspects of practice ownership including debt on graduation, the time period between graduation and acquiring practice ownership and small business skills. A mail survey of 400 dentists with practice ownership, in New South Wales (NSW) and the Australian Capital Territory (ACT), addressed demographics, setting up practice, technology and business management. Most respondents were male and nearly half had 20 years of practice ownership. Dentists agreed with the need to be taught small business management skills. Average debt on graduation was AUD$18 000 and the figure was higher for post 1995 graduates. On average, it took five years to acquire some form of practice ownership, but nearly half acquired ownership within three years. Few favoured opening a new practice. Staff were the most frequently nominated contributors to a successful practice, with fees, profit and parking noted least frequently. There was no question that these experienced dentists thought small business skills should be taught to the dental fraternity. Given the significance of staff to a successful practice, dentists may need to learn more about advanced human resource management including professional development and performance management.

Influence of gender on office staff management in orthodontics

To examine the gender differences in managing practice and staff members in orthodontic practices. All orthodontists in Virginia and Maryland (n = 427) were surveyed and demographic information was collected. For the crude analyses of the data, a Fisher's exact test or chi(2) test was performed. For the adjusted analyses, genders were compared using a logistic regression or analysis of covariance. The covariates were adjusted for age, program length, years in practice, number of years since graduation, and practice state. The length of the residency program attended did not differ with gender. No gender differences in practice ownership or creating the practice were observed. There was a significant gender difference in implementation of performance reviews: female orthodontists were more likely to provide performance reviews and tended to accept more poor reviews before staff termination than male orthodontists. However, when provided, no gender difference was observed in the number of performance reviews. Gender has a significant impact on the implementation of performance reviews in practices. Practice ownership status was not influenced by providers' gender.

Comparison of long-term financial implications for five veterinary career tracks

To compare present values of expected income streams for 5 distinct veterinary medical career tracks. Present value model. AVMA survey data. Present values of expected income streams (net of debt repayment) were created and ranked. Sensitivity to each independent variable was assessed. Career present value at 34 years after graduation (CPV(34)) was highest for board-certified specialist (SP; $2,272,877), followed by practice owner (PO; $2,119,596), practice owner buying into practice after 10 years (PO-10; $1,736,333), SP working three-fourths time (SP3/4; $1,702,744), and general practitioner (GP; $1,221,131). Compared with CPV(34) for SP, other career tracks yielded values of 93.3% (PO), 76.4% (PO-10), 74.9% (SP3/4), and 53.7% (GP). The model was robust to debt, interest rate, loan term, and discount rate but was sensitive to mean starting incomes and mean incomes. Greatest return on time and money invested by a veterinary student is through practicing full-time as an SP or through being a PO. Being an SP or SP3/4 was substantially more lucrative than being a GP and was comparable to being a PO. Practice ownership and working as an SP3/4 may be options for balancing financial gain with free time. Specialty training and practice ownership may be career tracks with the best potential repayment options for veterinarians with a large educational debt. Regardless of the amount of debt, the type of practice, mean incomes in a particular field, personal lifestyle, and professional interests are important factors when deciding among career tracks.

Exploring the impact of evolving health policy on independent pharmacy ownership in England

To study the impact of policy and contractual changes on community pharmacy ownership in England. North West of England. Twenty nine male pharmacists were interviewed between September 2007 and February. 2008. The study involved semi-structured face to face interviews with theoretically sampled respondents. Data were analysed using the constant comparative method. English community pharmacists' opinions and experiences. Practice ownership attracted some respondents to pharmacy as a career. Respondents considered that a combination of legislative and policy changes in combination with contractual alterations had decreased the profitability of independent pharmacy businesses. Additionally, it seemed that community pharmacy corporate groups were able to out bid individual pharmacists for community pharmacy businesses. A proportion of respondents had sold community pharmacy businesses recently, in some cases in response to contractual and policy changes. Some considered that the declining proportion of independent pharmacies was likely to limit patient choice as well as affecting the profession. Some felt this made pharmacy a less attractive career choice. It seems that recent policy and contractual changes have favoured the multiple community pharmacy sector in England, resulting in a declining proportion of independent community pharmacies. Policy makers must consider the far reaching consequences of this for pharmacists, the profession and patient choice.

Measuring physician contribution to the healthcare safety net

There are an estimated 46 million Americans without health insurance and an even larger number for whom health insurance does not cover all needed medical services. These individuals and families have to rely more and more on government programs and physicians’ willingness to provide uncompensated services, most often described by providers as charity care. Previous studies have shown a downward trend in the percent of physicians willing or able to provide charity care. We extend this research by examining the results of the Medical Group Management Association's Cost Survey of Medical Group Practices for 2005, 2006, and 2007. It is important to examine the uncompensated care reported by medical groups because groups have policies that may govern how much, if any, charity care their physicians provide. This survey data shows that, overall, the number of medical practices providing charity care continues to decline. The results and analysis of the survey data indicate that uncompensated (charity) care is being offered by less than half of medical practices, and at less than 2% of total gross charges. We examined the results by potential explanatory variables: population density, practice size, physician practice specialty, practice ownership structure, payer mix, and practice financial performance. Results were consistent across all categories; charity care is declining. These results have major policy implications for both the federal government and all state governments, especially in light of the current recession and proposed healthcare reform legislation.

Inclusion or Exclusion? Local Ownership and Security Sector Reform

This paper explores the dynamics of security sector reform (SSR), a term used to refer to efforts made to reform the security structures of states emerging from conflict or authoritarianism. While "local ownership" is increasingly viewed as a necessary element of any sustainable SSR strategy, there remains a significant gap between international policy and practice in this area. In practice, the SSR agenda continues to be driven largely by international actors, with minimal input, let alone ownership, on the part of either governments or civil society within reforming states. Indeed, the notion of local ownership has come to serve as much as a disciplining mechanism as a tool to overcome exclusion in the making and execution of security policy, and the effectiveness and sustainability of SSR programming have suffered as a result. In light of this, the paper will explore both the potential for, and the limits of, rehabilitating the notion of local ownership to enable more participatory forms of SSR, and argues that any practical local ownership strategy requires a dual policy of negotiating with state actors and engaging with non-state actors.

Barriers to Practice Ownership Survey

Barriers to Practice Ownership Survey

Claiming Culture: New Definitions and Ownership of Cultural Practices in Manus Province, Papua New Guinea

In the past in Manus Province, Papua New Guinea, specialised practices, such as the construction of canoes or traditional slit-drums (garamuts), were the property of patrilineal descent groups. Today, processes of objectification of traditions have generated new cultural identifications and redefined the ways skills are perceived as resources and can be claimed as property. The present article traces contemporary developments of notions of tradition and culture in Manus and discusses these in the light of empirical material obtained in connection with the preparations for an ethnographic exhibition on Manus. The argument is that cultural practices classified as kastam are part of local interpretations of cultural differences in ways that seem contingent with precolonial ‘cultural totemism’ but, as knowledge, cultural practices can also be transacted.

The Geographic Distribution, Ownership, Prices, and Scope of Practice at Retail Clinics

Retail clinics are clinics within a retail store that provide simple acute and preventive care services for a fixed price without an appointment. To describe characteristics of retail clinics, including their location, scope of practice, prices, acceptance of insurance, and ownership, and to estimate the proportion of the U.S. population that lives within a short driving distance of such a clinic. Cross-sectional descriptive study. United States. All 982 retail clinics operating as of August 2008. Population living within a 5- and 10-minute driving distance of a retail clinic. In August 2008, 42 operators ran 982 clinics in 33 states; 88.4% were located in urban areas. Nearly half (44%) of all clinics were located in 5 states (Florida, California, Texas, Minnesota, and Illinois). All offered sore throat treatment (average price, $78) and more than 95% offered treatment of skin conditions, immunizations, pregnancy testing, and lipid or diabetes screening. Almost all (97%) accepted private insurance and Medicare fee-for-service (93%). Among 42 clinic operators, 25 are existing health care companies that operate 11% of the clinics, and 3 are for-profit retail chains that operate 73% of the clinics. An estimated 10.6% of the total U.S. and 13.4% of the urban U.S. population lives within a 5-minute driving distance of a retail clinic, whereas 28.7% (total) and 35.8% (urban) live within a 10-minute driving distance. Our inventory of clinics stopped in August 2008 and estimates of proximity are based on 2000 census data. Retail clinics are positioned to provide immunizations and care for simple acute conditions for a substantial segment of the urban U.S. population. California Healthcare Foundation.

2007 Survey of Radiologists: Practice Characteristics, Ownership, and Affiliation With Imaging Centers

2007 Survey of Radiologists: Practice Characteristics, Ownership, and Affiliation With Imaging Centers

ADA charts course to nurture a “culture of practice ownership” in audiology

ADA charts course to nurture a “culture of practice ownership” in audiology

Recording Artists, Work for Hire, Employment, and Appropriation

Authorship and ownership exist in a curious relation in U.S. copyright law. In theory and common sense, authorship underwrites and is the condition of ownership, but in practice ownership can establish authorship retroactively. Distinctions between proprietary and non-proprietary creative cultural workers, in this view, turn in no essential way on evidence of creativity or the investment of personality in cultural creation. This paper examines a legislative struggle between recording artists and the recording industry over the status of their stock-in-trade, sound recordings. In 2000, recording artists obtained the repeal of a 1999 law allocating authorship and ownership of recordings to their record company contractors through the former's assertions not of authorship in the commonsense understanding, but through the artists' legal ability to alienate their employed backup musicians, engineers and other creative personnel. Analyzing this struggle against the backdrop of a historical/theoretical consideration of the dynamics of domination and dispossession naturalized in the employment relationship, I show how the political-economic organization of creative production in the cultural industries depends crucially on and further naturalizes this legal furniture of the social world (Ellerman, 1992), as much or more than it does on immanent aspects of cultural products or production processes.

2007 Survey of Radiologists: Practice Characteristics, Ownership, and Affiliation With Imaging Centers

The ACR conducts periodic surveys to assess the status of radiologists and their practices. The most recent survey was in 2007. One purpose of the survey was to obtain up-to-date data on top-line parameters on radiologists and their practices. That is the focus of this article, the first of two JACR articles highlighting the survey's findings. The 2007 survey was a stratified random-sample telephone quota survey of ACR radiologist members and practice leaders conducted in May and June 2007. In total, 601 responses were received from currently practicing radiologists. The response rate was 20%, and the margin of error was +/-4.3% at the 95% confidence level. Survey results presented in this article fall into 3 areas, which include characteristics of radiologists and their practices, ownership of imaging equipment, and the affiliation of radiologists with nonhospital imaging centers. Some highlights are as follows: interventional radiology and neuroradiology were the most frequently reported subspecialties; the mean practice size was 20 full-time radiologists; radiologists worked an average of 50 hours per week, took 8 weeks of vacation per year, and performed 14,000 imaging studies annually; slightly more than half of radiologists owned imaging equipment, with magnetic resonance and computed tomographic scanners being the most likely equipment to be owned; nearly one-half said that they had equity interest in centers, 36% provided services to centers under contract, fewer than 5% were employees of centers, and the remaining nearly one-third reported no affiliation of any kind.

μWith good chemistry and communication, practice partnerships can be powerful

Sharing ownership of a hearing care practice with a partner has both risks and potential advantages. Some practitioners who have made partnership succeed tell how.

The practice of primary care sports medicine in the USA

Objective:To investigate and to characterise the practice patterns, academic rank, and income variables that exist in order to better understand the career of a sports medicine physician in the USA.Design:A...

Effects of changes in incomes and practice circumstances on physicians' decisions to treat charity and Medicaid patients.

The decline over the past decade in the percentage of physicians providing care to charity and Medicaid patients has been attributed to both financial pressure and the changing practice environment. Policymakers should be concerned about these trends, since private physicians are a major source of medical care for low-income persons. This study examines how changes in physicians' practice income, ownership, and size affect their decisions to stop or start treating charity care and Medicaid patients. This study uses panel data from four rounds of the Community Tracking Study Physician Survey. The dependent variables are the likelihood of physicians' (1) dropping charity care, (2) starting to provide charity care, (3) no longer accepting new Medicaid patients, and (4) starting to accept new Medicaid patients. The primary independent variables are changes in physicians' practice income, ownership, and practice type/size. Multivariate analysis controls for the effects of other physician practice characteristics, health policies, and health care market factors. A decline in physicians' income increased the likelihood that a physician would stop accepting new Medicaid patients but had no effect on his or her decision to provide charity care. Those physicians who switched from being owners to employees or from small to larger practices were more likely to drop charity care and to start accepting Medicaid patients, and physicians who made the opposite practice changes did the reverse. Changes in their income and practice arrangements make physicians less willing to accept Medicaid and uninsured patients. Moreover, physicians moving into different practice arrangements treat charity and Medicaid patients as substitutes rather than as similar types of patients. To reverse these trends, policymakers should consider raising Medicaid reimbursement rates and subsidizing organizations that encourage private physicians to provide charity care.

Buoyed by a new name and mission, ADA sets forth on a new beginning

During its annual convention, the Academy of Doctors of Audiology discussed a whitepaper calling for private practice ownership to become the prevailing practice model for the profession by the year 2020.

Satisfaction of Radiologists in the United States: A Comparison between 2003 and 1995

To prospectively ascertain what characteristics of radiologists, their practices, and their work environment affect professional satisfaction and to describe recent changes in satisfaction. Survey respondents were guaranteed confidentiality. Those who consented to participate were informed of the nature of the study. The authors analyzed nonindividually identified data from the American College of Radiology 2003 Survey of Radiologists, a nationally representative, confidential, stratified random-sample mail survey of radiologists in the United States, which had a 63% response rate, with a total of 1924 responses. Data were weighted to be representative of all U.S. radiologists and were analyzed by using univariate and multivariate analyses. The five answer options to questions regarding level of satisfaction corresponded to scores of +2, +1, 0, -1, and -2. Results were compared with those of a similar 1995 survey. Although 93% of radiologists enjoyed radiology very much or somewhat, the mean satisfaction score for posttraining professionally active radiologists decreased from 1.62 in 1995 to 1.47 in 2003. Thirty-two percent of radiologists reported enjoying radiology more than 5 years ago; 41% said they enjoyed it less. Excessive workload reduced current satisfaction and satisfaction relative to 5 years ago. Working in the Midwest enhanced current satisfaction and satisfaction relative to 5 years ago. Practice type and practice ownership had more varied effects on professional satisfaction; subspecialty type had relatively little effect. In 2003, medicolegal climate, workload, and reimbursement and/or financial pressures were the three most common reasons for decreased satisfaction. In 1995, interference from managed care; government regulations, control, and red tape; and increased administrative burden were the three most common reasons. Lifestyle and/or work hours, and income were the most common causes of increased satisfaction in 2003, but these were also often mentioned as causes of decreased satisfaction. Radiologists have higher levels of professional satisfaction than do other physicians; however, as with physicians overall, their satisfaction has decreased over time.

The Practice of Primary Care Sports Medicine Physicians

BACKGROUND: Primary care sports medicine began in the 1970's and has grown into a well recognized sub-specialty of family medicine. Fellowships were developed in the 1980's, and the ABFP formally certified its members with a Certificate of Added Qualification in 1993. The practice of the 1,102 family physicians with a CAQ in sports medicine varies significantly. Therefore, we felt it important to investigate and disseminate the practice patterns, career opportunities, professional relationships, and income that exist in order to better understand the career of a sports medicine physician. PURPOSE: To characterize the clinical practices of physicians who hold a Certificate of Added Qualification in Sports Medicine through the American Board of Family Physicians. METHODS: A non-identifiable web-based survey was distributed via e-mail by the ABFP to all 862 family physicians, with a valid e-mail address, holding a CAQ in Sports Medicine. Survey questions included physician, practice, patient and payer demographics as well as income data. Statistical analysis of the data was done using Pearson Chi2 and Fisher's Exact tests. RESULTS: A total of 862 e-mails were distributed by the American Board of Family Medicine. Of these, 325 surveys were successfully completed for an overall return rate of 38%. Of respondents currently holding a CAQ, 212 reported completing a Primary Care Sports Medicine Fellowship. Furthermore, 276 were male and 49 were female, and 300 reported being a M.D., while 25 reported being a D.O. Of the 325 responses, the average net income for all physicians with a CAQ in Sports Medicine was $166, 348. Practice characteristics related to a high income (>200, 000/year) included the following: age > 40 (p = 0.004, odds ratio = 3.51); male gender (p = 0.015, odds ratio = 6.64); owner of a private practice (p = 0.003, odds ratio = 3.58); and seeing > 10 patients per half day (p = 0.000, odds ratio 5.83). There was no statistical difference between salaries for the following variables: MD vs. DO, OMT practice, region of the country, or type of practice. CONCLUSIONS: The practice of primary care sports medicine physicians varies significantly with location and type of practice. Salary can be related to age, gender, number of patients seen, and practice ownership.

Women Radiologists in the United States: Results from the American College of Radiology's 2003 Survey

To retrospectively evaluate data from the 2003 American College of Radiology (ACR) survey of diagnostic radiologists with regard to characteristics of women radiologists, their professional activities, and the practices in which they work. The authors analyzed nonindividually identified data from the ACR's 2003 Survey of Radiologists, a stratified random sample survey that guaranteed respondents confidentiality. A cover letter assured respondents that no individually identifiable information would be disseminated; to further enhance confidentiality, survey operations were conducted by a contractor rather than by the ACR itself. There was a 63% response rate, with a total of 1924 responses. Responses were weighted to make them representative of all radiologists in the United States. Two-tailed z tests of percentages and means and multiple regression analysis were used to compare information for women radiologists with that for men radiologists. Twenty-four percent of radiologists in training (residents and fellows) and 18% of posttraining, professionally active radiologists were women. Forty-one percent of posttraining, professionally active women were younger than 45 years in comparison with 29% of men (P = .004). Women radiologists were more likely to have fellowship training than men (69% vs 60%, P = .007), although they were less likely than men to have a subspecialty certificate (16% vs 27%, P < .001). Thirty-nine percent of women and 16% of men worked part-time (P < .001). Women were more concentrated in academia (22% vs 14%, P = .009) and breast imaging (27% vs 6%, P < .001) than their male peers but were underrepresented in interventional radiology (2% vs 13%, P < .001) and neuroradiology (3% vs 10%, P < .001). In situations where radiologists are likely to be practice owners, fewer women than men were owners (75% vs 91%) (P = .011). Women reported the same level of enjoyment of radiology as did men. Women radiologists differ from men in regard to age, fellowship training, full- versus part-time employment, academic versus nonacademic practice, subspecialty practice, and practice ownership.