TY - JOUR
T1 - Community size and organization of practice predict family physician recertification success
AU - Schulte, Bradley M.
AU - Mannino, David M.
AU - Royal, Kenneth D.
AU - Brown, Sabrina L.
AU - Peterson, Lars E.
AU - Puffer, James C.
N1 - Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2014
Y1 - 2014
N2 - Objective: Health disparities exist between rural and urban areas. Rural physicians may lack sufficient medical knowledge, which may lead to poor quality of care. Therefore, we sought to determine whether medical knowledge differed between family physicians (FPs) practicing in rural areas compared with those practicing in metropolitan areas. Methods: We studied 8361 FPs who took the American Board of Family Medicine maintenance of certification (MOC) examination in 2009. Data sources were examination results and data from a demographic survey of practice structure and activities, completed as part of the examination application process. FPs' location of practice was categorized as either rural or metropolitan using a moderate and conservative definition based on reported community size. Univariate statistics assessed differences in FP characteristics between rural and metropolitan areas. Logistic regression analyses determined the adjusted relationship between rural status and the odds of passing the MOC examination. Results: Metropolitan FPs were less likely than their rural counterparts to pass the MOC examination using both the moderate (odds ratio, 0.67; 95% confidence interval, 0.54-0.83) and conservative (odds ratio, 0.56; 95% confidence interval, 0.42- 0.74) definitions. Physicians in solo practice were less likely to pass the examination than physicians in group practice. Conclusion: Rural physicians were more likely to pass the MOC examination, suggesting that rural health disparities do not result from a lack of provider knowledge.
AB - Objective: Health disparities exist between rural and urban areas. Rural physicians may lack sufficient medical knowledge, which may lead to poor quality of care. Therefore, we sought to determine whether medical knowledge differed between family physicians (FPs) practicing in rural areas compared with those practicing in metropolitan areas. Methods: We studied 8361 FPs who took the American Board of Family Medicine maintenance of certification (MOC) examination in 2009. Data sources were examination results and data from a demographic survey of practice structure and activities, completed as part of the examination application process. FPs' location of practice was categorized as either rural or metropolitan using a moderate and conservative definition based on reported community size. Univariate statistics assessed differences in FP characteristics between rural and metropolitan areas. Logistic regression analyses determined the adjusted relationship between rural status and the odds of passing the MOC examination. Results: Metropolitan FPs were less likely than their rural counterparts to pass the MOC examination using both the moderate (odds ratio, 0.67; 95% confidence interval, 0.54-0.83) and conservative (odds ratio, 0.56; 95% confidence interval, 0.42- 0.74) definitions. Physicians in solo practice were less likely to pass the examination than physicians in group practice. Conclusion: Rural physicians were more likely to pass the MOC examination, suggesting that rural health disparities do not result from a lack of provider knowledge.
KW - Certification
KW - Community
KW - Organizational structure
KW - Rural health
KW - Specialty boards
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U2 - 10.3122/jabfm.2014.03.130016
DO - 10.3122/jabfm.2014.03.130016
M3 - Article
C2 - 24808117
AN - SCOPUS:84900538823
SN - 1557-2625
VL - 27
SP - 383
EP - 390
JO - Journal of the American Board of Family Medicine
JF - Journal of the American Board of Family Medicine
IS - 3
ER -