Assessing the Accuracy of Three National Physician Sampling Frames

Henderson, Mary

doi:10.1007/s11606-015-3483-3

Cited by 7 publications

(11 citation statements)

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“…Second, there are known issues with the AMA-Master file including under/overcounting physicians in different practice settings or specialties [ 41 ]. Despite this, the AMA has been the best available source for US physician workforce data [ 9 , 42 – 44 ]. Third, for the comparisons, we looked separately at the 2005 and 2015 cohorts.…”

Section: Discussionmentioning

confidence: 99%

A comparison of physician emigration from Africa to the United States of America between 2005 and 2015

2017

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BackgroundMigration of health professionals has been a cause for global concern, in particular migration from African countries with a high disease burden and already fragile health systems. An estimated one fifth of African-born physicians are working in high-income countries. Lack of good data makes it difficult to determine what constitutes “African” physicians, as most studies do not distinguish between their country of citizenship and country of training. Thus, the real extent of migration from African countries to the United States (US) remains unclear. This paper quantifies where African migrant physicians come from, where they were educated, and how these trends have changed over time.MethodsWe combined data from the Educational Commission for Foreign Medical Graduates with the 2005 and 2015 American Medical Association Physician Masterfiles. Using a repeated cross-sectional study design, we reviewed the available data, including medical school attended, country of medical school, and citizenship when entering medical school.ResultsThe outflow of African-educated physicians to the US has increased over the past 10 years, from 10 684 in 2005 to 13 584 in 2015 (27.1% increase). This represents 5.9% of all international medical graduates in the US workforce in 2015. The number of African-educated physicians who graduated from medical schools in sub-Saharan countries was 2014 in 2005 and 8150 in 2015 (304.6% increase). We found four distinct categorizations of African-trained physicians migrating to the US: (1) citizens from an African country who attended medical school in their own country (86.2%, n = 11,697); (2) citizens from an African country who attended medical school in another African country (2.3%, n = 317); (3) US citizens who attended medical school in an African country (4.0%, n = 537); (4) citizens from a country outside Africa, and other than the United States, who attended medical school in an African country (7.5%, n = 1013). Overall, six schools in Africa provided half of all African-educated physicians.ConclusionsThe number of African-educated physicians in the US has increased over the past 10 years. We have distinguished four migration patterns, based on citizenship and country of medical school. The majority of African graduates come to the US from relatively few countries, and from a limited number of medical schools. A proportion are not citizens of the country where they attended medical school, highlighting the internationalization of medical education.

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Section: Discussionmentioning

confidence: 99%

A comparison of physician emigration from Africa to the United States of America between 2005 and 2015

2017

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“…There are a number of limitations of our study. First, the underlying data set, the AMA Masterfile, has been reported to under/over-represent different specialties and practice settings [53, 54]. Second, some of the variables used in the analyses were self-reported (e.g., primary self-designated specialty, citizenship) and may be subject to error.…”

Section: Discussionmentioning

confidence: 99%

Supply, distribution and characteristics of international medical graduates in family medicine in the United States: a cross-sectional study

2019

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Background To describe the supply, distribution, and characteristics of international medical graduates (IMGs) in family medicine who provide patient care in the U.S. Methods A cross-sectional study design, using descriptive statistics on combined data from the Educational Commission for Foreign Medical Graduates and the American Medical Association, including medical school attended, country of medical school, and citizenship when entering medical school. Results In total, 118,817 physicians in family medicine were identified, with IMGs representing 23.8% ( n = 28,227) of the U.S. patient care workforce. Of all 9579 residents in family medicine, 36.0% ( n = 3452) are IMGS. In total, 35.9% of IMGs attended medical school in the Caribbean ( n = 10,136); 19.9% in South-Central Asia ( n = 5607) and 9.1% in South-Eastern Asia ( n = 2565). The most common countries of medical school training were Dominica, Mexico, and Sint Maarten. Of all IMGs in family medicine who attended medical school in the Caribbean, 74.5% were U.S. citizens. In total, 40.5% of all IMGs in family medicine held U.S. citizenship at entry to medical school. IMGs comprise almost 40% of the family medicine workforce in Florida, New Jersey and New York. Conclusions IMGs play an important role in the U.S. family medicine workforce. Many IMGs are U.S. citizens who studied abroad and then returned to the U.S. for graduate training. Given the shortage of family physicians, and the large number of IMGs in graduate training programs, IMGs will continue to play a role in the U.S. physician workforce for some time to come. Many factors, including the supply of residency training positions, could eventually restrict the number of IMGs entering the U.S., including those contributing to family practice.

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“…Practice ZIP code was found across all 3 datasets, ensuring a common variable for analysis. This is also an attempt to address the concerns of Henderson (2015), when comparing the databases by using office location rather than the physicians preferred address. The data obtained from the AMA Masterfile did not include the street address for identification purposes; only the practice ZIP code.…”

Section: Methodsmentioning

confidence: 99%

“…The NPPES and SK&A had higher address concordance rates (72% to 94% and 79% to 92% respectively, across specialties). However, Henderson (2015) noted that DesRoches et al's methodologic use of the AMA's Physician Preferred Address prevented a meaningful comparison of the databases since the Physician's Preferred Address is subjectively provided by the physician and by definition could vary from practice ZIP, home residence ZIP, or other location. (The AMA allows physicians to indicate a preferred mailing address, which may not be a physician's actual practice address).…”

Section: Introductionmentioning

confidence: 99%

“…(The AMA allows physicians to indicate a preferred mailing address, which may not be a physician's actual practice address). 19 Henderson asserts that comparing this address to that in the NPPES and SK&A databases may have resulted in lower match rates. Freed et al (2006), while assessing the distribution and number of pediatric cardiologists, found that only 58% were listed by both the AMA Masterfile and the American Board of Pediatrics.…”

Section: Introductionmentioning

confidence: 99%

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Physician Practice Location

Onello

Bright

Boulger

2019

JRMC

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Purpose: This study compares and contrasts locational identification (physician practice ZIP code) between several physician demographic databases and a research team-verified ZIP code to determine spatial concordance. Accuracy of physician location data is critical for both successful national physician workforce planning and for assessing the fulfillment of distinct regional medical school missions. Methods: Three physician databases; the American Medical Association’s Physician Masterfile, the National Provider and Plan Enumeration System (NPPES), and the Minnesota Board of Medical Practice’s Licensure File were compared against each other as well as a set of actively verified practice location ZIP codes. A sampling frame of medical school alumni from 2003 to 2014 was selected. The sample included alumni from both regional and main campuses. From this alumni sample, a random sample of four hundred individuals were selected for closer examination. Descriptive frequencies are presented for the concordance of ZIP codes for the sample of four hundred alumni. Findings: From an initial cohort of 2,605 University of Minnesota medical school alumni, a sample of 400 who also possessed a Minnesota medical license were randomly selected to examine concordance rates. The highest rate of concordance was the verified ZIP code and the Minnesota Licensure Board practice ZIP code at 68.8%. Only 42.0% of practice location ZIP codes matched across all databases. Conclusions: The concordance rate across practice ZIP codes in the databases does not inspire confidence in ability to characterize true physician practice location. Some of the difficulties in defining, identifying and maintaining information on physician practice location are discussed. Without accurate and precise practice location information, the development and implementation of comprehensive national health policies for the United States may face difficulties. The lack of reliable physician practice location data also presents a challenge to regional medical school campuses that depend upon accurate physician location data to evaluate progress toward mission-directed workforce goals.

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Assessing the Accuracy of Three National Physician Sampling Frames

Cited by 7 publications

References 1 publication

A comparison of physician emigration from Africa to the United States of America between 2005 and 2015

A comparison of physician emigration from Africa to the United States of America between 2005 and 2015

Supply, distribution and characteristics of international medical graduates in family medicine in the United States: a cross-sectional study

Physician Practice Location

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