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This study comprises the second round of the physician survey component of the Community Tracking Study (CTS) sponsored by the Robert Wood Johnson Foundation. The CTS is a national study designed to track changes in the American health care system and the effects of the changes on care delivery and on individuals. Central to the design of the CTS is its community focus. Sixty sites (51 metropolitan areas and 9 nonmetropolitan areas) were randomly selected to form the core of the CTS and to be representative of the nation as a whole. As in the first round of the physician survey (COMMUNITY TRACKING STUDY PHYSICIAN SURVEY, 1996-1997: [UNITED STATES] (ICPSR 2597)), the second round was administered to physicians in the 60 CTS sites and to a supplemental national sample of physicians. The survey instrument collected information on physician supply and specialty distribution, practice arrangements and physician ownership of practices, physician time allocation, sources of practice revenue, level and determinants of physician compensation, provision of charity care, career satisfaction, physicians' perceptions of their ability to deliver care, views on care management strategies, and various other aspects of physicians' practice of medicine. In addition, primary care physicians (PCPs) were asked to recommend courses of action in response to some vignettes of clinical presentations for which there was no prescribed method of treatment.

Dataset 3, the Site and County Crosswalk Data File, identifies the counties that constitute each CTS site.

Dataset 4, the Physician Survey Summary File, contains site-level estimates and standard errors of the estimates for selected physician characteristics, e.g., the percentage of physicians who were foreign medical school graduates, the mean age of physicians, and the mean percentage of patient care practice revenue from Medicaid.

For people with serious chronic conditions, healthcare that defaults to all available treatments without considering patient preferences risks harms that may exceed benefits. Advance care planning (ACP) has the potential to align healthcare with what is important to patients and maximize quality of life. While primary care is where most people receive most of their care, engaging patients in ACP is not routine in primary care given competing demands and limited resources. Primary care clinicians, patients, and families agree that it is preferred to make plans before there is a medical crisis. The research team's goal was to make ACP routine in primary care and to "move it upstream" so that it included improving the quality of the last years of life as well as respecting wishes for end of life care.

This study included a comparative effectiveness trial of team-based versus individual clinician-focused ACP in primary care practices. The research team adapted Ariadne Labs' Serious Illness Care Program (SICP) and aimed to determine if a team approach produces better patient outcomes and explore factors influencing implementation of ACP across practices.

Seven practice-based research networks (PBRNs) in the United States and Canada randomized their primary care practices to team-based or individual clinician-focused versions of SICP. Team members and clinicians completed training, and implementation was supported through practice facilitation. Consented patient participants completed a baseline survey after initial conversations and follow-up surveys at 6 and 12 months later. Forty practices (21 team, 19 clinician) completed training and referred patients to the study. Half of the practices were rural, 80 percent were family medicine, and 33 percent were medical residency training sites. 535 healthcare staff completed training. Both arms trained primary care providers; the team arm also trained nurses, medical assistants, and other roles. 1,321 patients and care partners were referred; and 917 consented and were enrolled (455 from team practices, 462 from clinician). Data from 802 patients were included in the primary analyses. Qualitative implementation data was collected during practice facilitation and from practice interviews.

This collection includes quantitative data collected from primary care practices (DS1) and team members and clinicians (DS2) from study sites located in the United States.

Funded by the Robert Wood Johnson Foundation, the National Study of Small and Medium-sized Physician Practices (NSSMPP) was designed to provide information about physician practices with 1-19 physicians. The survey focused on the use of information technology and care management processes for four major chronic illnesses: asthma, congestive heart failure, depression, and diabetes. Other topics covered by the survey include practice type, size, ownership and the breakdown of patients by race and Hispanic origin; clinical preventative services and health promotion; health insurance plan activities in preventative care and care for patients with chronic illness; performance reporting and incentives; revenue sources and compensation methods; and organizational culture.

NSSMPP was also designed to assist the RWJF-funded Aligning Forces for Quality (AF4Q) project by providing baseline data about small and medium sized practices in the AF4Q sites. AF4Q was a national program that aimed to lift the quality of health care in 16 targeted communities, reduce racial and ethnic disparities in those communities and provide models for national reform.

NSSMPP built on two previous studies -- the National Study of Physician Organizations and the Management of Chronic Illness (NSPO), 2000-2001 (ICPSR 4455) and the National Study of Physician Organizations and the Management of Chronic Illness II (NSPO2), 2006-2007 (ICPSR 29801) -- which collected information about medical groups and independent practice associations (IPAs) with 20 or more physicians.

This study investigated the factors that influenced the career decisions of young physicians and the characteristics of their practices. The collection has five datasets: Public-Use Version of the Young Physicians Survey (Dataset 1), Socioeconomic Monitoring System Study (Dataset 2), ZIP Code Data (Dataset 3), Verbatim Responses to the Open-Ended Questions (Dataset 4), and Restricted-Use Version of the Young Physicians Survey (Dataset 5).

The Public-Use Version of the Young Physicians Survey comprises responses from the Young Physicians Survey (YPS), plus merged data from the American Medical Association (AMA) Masterfile and the Association of American Medical Colleges' Student and Applicant Information Management System (SAIMS) database. The YPS interviewed physicians below 40 years of age who recently completed graduate medical training and were in their early years of practice. These physicians were queried about their graduate medical training, perceptions of the medical profession, current practice arrangements, career decisions, family background, patient care activities, and current income and expenses. To obtain information on current practice arrangements, respondents were questioned about the practices they worked in, including who owned the practices, the number of physicians in each practice, specialties or subspecialties practiced, usual fees for selected services, percentages of revenues from HMOs, PPOs, and IPAs, and percentages of patients who were Medicare patients, had no health insurance coverage, or were poor, Black, Hispanic, severely physically disabled, or chronically mentally ill. Questions on career decisions asked respondents about factors that influenced their career choices, such as reasons for working in multiple practices, reasons for leaving past practices, and reasons for deciding in favor of or against self-employment. Information on family background elicited by the survey includes the respondent's race, marital status, and educational debt, parents' income class and education, number of children living in the respondent's home, and whether the respondent's spouse or parents were physicians. Questions on patient care activities included questions on the number of hours spent providing uncompensated health care to the poor, and the number of hours spent with patients in a variety of settings, such as the office, emergency rooms, hospital outpatient clinics, and operating rooms. Information from the AMA Masterfile and the SAIMS database includes board certification status, AMA membership, school and year of graduation, Medical College Admission Test scores, primary undergraduate institution, most recent grade point averages, place of birth, number of acceptances to United States medical schools, parents' occupations, preferred medical specialty, and preferred practice setting.

Dataset 2 comprises responses from the AMA's Socioeconomic Monitoring System (SMS), a semiannual survey of nonfederal physicians that collected data on topics similar to those in the YPS, such as practice ownership, hours spent seeing patients in various settings, income, expenses, and opinions on practice procedures. The SMS data can be used for comparative analyses of young, prime, and senior physicians.

The ZIP Code Data contain estimates for the composition of the population residing in the ZIP code areas of the YPS respondents' main practices. This includes estimates of the size of each ZIP code area population, as well as its components with respect to gender, age, race, Hispanic ethnicity, and income. Also included are estimates of the number of physicians and their composition with respect to age, sex, practice type, and specialty.

Dataset 4 contains verbatim responses to open-ended questions asked in the YPS.

The Restricted-Use Version of the Young Physicians Survey is the same as the Public-Use Version of the Young Physicians Survey, except for some variables that were restricted from general dissemination for reasons of confidentiality. The restricted-use version includes the restricted variables, but the public-use version does not.

The purpose of this survey was to obtain information on the characteristics and practice patterns of early career physicians in order to analyze trends in physicians' activities and the supply of physicians. To that end, the survey interviewed early career physicians and re-interviewed physicians who participated in the previous survey of early career physicians PRACTICE PATTERNS OF YOUNG PHYSICIANS, 1987 (ICPSR 9277). With separate samples drawn for allopathic and osteopathic physicians, the respondents were interviewed about their medical training, medical education financing, career choices and satisfaction, practice arrangements and compensation, and patient care activities. They were also questioned about medical care management in their practice(s), perceptions of their freedom to deliver care, medical malpractice claims, and the composition of their patients, such as the percent who were poor, black, Hispanic, uninsured, covered by Medicaid or Medicare, or had severe physical disabilities, chronic mental illness, or problems with substance abuse. Demographic characteristics covered by the survey include race, Hispanic origin, year of birth, marital status, number and ages of children, and parents' education.

In addition to the variables collected by survey, the allopath sample data also comprise variables obtained from the American Medical Association (AMA) and the Student and Applicant Information Management System (SAIMS) of the Association of American Medical Colleges (AAMC). The AMA variables include gender, name of medical school, board certification status, physician's specialty, and AMA membership, while the SAIMS variables include dates of application to medical school, graduation dates, Medical College Admission Test (MCAT) scores, undergraduate grade-point averages, religious preference, career preference, preferred practice setting, educational debt, scholarship information, and participation in courses/clerkships in different subject areas.

The study comprises five data files. Dataset 1 contains the public-use version of the data for the allopath sample and Dataset 2 the public-use version of the data data for the osteopath sample. Both of these files were generated by ICPSR from the original restricted-use allopath and osteopath data files provided by the principal investigator, which are stored as Datasets 3 and 4 respectively. As noted in the ICPSR Processing Note in the codebook, Dataset 5 contains 26 restricted variables which the principal investigator omitted from the original allopath data (Dataset 3) for reasons of confidentiality. ICPSR received the omitted variables in 2009, 14 years after its initial release of the data.

Prescription for Health was an initiative funded by the Robert Wood Johnson Foundation in collaboration with the Agency for Healthcare Research and Quality. Under this initiative, primary care practice-based research networks (PBRNs) -- groups of ambulatory practices devoted principally to the primary care of patients -- developed, tested, and evaluated innovative strategies to improve the delivery and effectiveness of health behavior change services in primary care practice. The strategies targeted four health risk behaviors: tobacco use, unhealthy diet, lack of physical activity, and risky alcohol use. Prescription for Health was conducted in two rounds. Round one awarded grants to 17 PBRNs to test the feasibility of implementing the strategies, while round two awarded grants to ten PBRNs to measure the strategies' effectiveness and the expenses associated with them. More than a 100 primary care practices from the ten PBRNs participated in the evaluation.

This data collection comprises the data from one of the data collection efforts carried out by the second round: the responses to the Practice Information Form (PIF), a Web-based instrument which captured key organizational attributes of the participating practices. The PIF data were collected at two time points. Baseline data were collected from each practice before the intervention was implemented and follow-up data were collected approximately one year after the start of the intervention.

Information about the practices collected by the PIF include practice type and ownership; characteristics of each clinician and non-clinician staff person; number of vacancies for clinicians and non clinicians; number of exam rooms and volume of office visits; average number of new patients per month; percentages of patients in various age, race, Hispanic origin, and payer categories; and the predominant type of payment arrangement with health plans. In addition, the PIF asked whether a specific health plan controlled over half of the practice's total business; whether the practice had a pay-for-performance program; whether any payers or organizations publicly reported practice level performance information, such as patient satisfaction, chronic care/disease management, and/or preventive service delivery; and whether practices had a formal process for routinely measuring satisfaction among patients, clinicians, and other staff. The PIF also investigated how practices motivated their clinicians and staff; the level of competition among practices in local markets; the use of computers, electronic medical record systems, and patient registries; major changes that affected each practice's ability to make improvements in patient care; factors that prevented practices from translating the results of research into changes in medical practice; and the use of health risk assessment protocols or questionnaires to identify patients who may benefit from counseling or interventions. Questions about the four Prescription for Health behaviors -- physical activity, healthy eating, smoking cessation, and addressing risky drinking -- asked how practices linked patients to outside resources for each of the four behaviors; how practices used evidence-based guidelines and informed patients about recommendations for the behaviors; and which approaches practices used to support patients ready to engage in a behavior change for each of the behaviors.