%0 Journal Article
%T Primary Healthcare Solo Practices: Homogeneous or Heterogeneous?
%A Raynald Pineault
%A Roxane Borg¨¨s Da Silva
%A Sylvie Provost
%A Marie-Dominique Beaulieu
%A Antoine Boivin
%A Audrey Couture
%A Alexandre Prud'homme
%J International Journal of Family Medicine
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/373725
%X Introduction. Solo practices have generally been viewed as forming a homogeneous group. However, they may differ on many characteristics. The objective of this paper is to identify different forms of solo practice and to determine the extent to which they are associated with patient experience of care. Methods. Two surveys were carried out in two regions of Quebec in 2010: a telephone survey of 9180 respondents from the general population and a postal survey of 606 primary healthcare (PHC) practices. Data from the two surveys were linked through the respondent¡¯s usual source of care. A taxonomy of solo practices was constructed ( ), using cluster analysis techniques. Bivariate and multilevel analyses were used to determine the relationship of the taxonomy with patient experience of care. Results. Four models were derived from the taxonomy. Practices in the ¡°resourceful networked¡± model contrast with those of the ¡°resourceless isolated¡± model to the extent that the experience of care reported by their patients is more favorable. Conclusion. Solo practice is not a homogeneous group. The four models identified have different organizational features and their patients¡¯ experience of care also differs. Some models seem to offer a better organizational potential in the context of current reforms. 1. Introduction Recent reforms in healthcare delivery have greatly modified primary care medical practice, by fostering the grouping of physicians into more complex and large organizations [1]. Consequently, the number of solo practices has decreased considerably. In Canada, the percentage of physicians in solo practice was estimated at 51.8% in 1986-1987 [2]. In 1997, this figure had decreased to 31.3% and in 2010 to only 22.3%. Male and older physicians were proportionally overrepresented in this mode of practice [2¨C5]. This trend has also been observed in other countries, namely, in The Netherlands where the percentage of solo practitioners decreased from 67.4% in 1990 to 39.1% in 2010, while group practice increased proportionally [6, 7]. A decrease in small practices has also been reported in the UK [8]. Echoing this trend, solo medical practice has been considered obsolete [9]. However, analysts are not unanimous, as many contend that small practices, including solo practices, must be maintained [10]. Solo practice is cherished by many doctors, because it fosters greater professional autonomy, a core value of the medical profession [1, 11]. Networking, either through formal collaborative agreement or patients¡¯ referral and affiliation with other practice
%U http://www.hindawi.com/journals/ijfm/2014/373725/