Physician productivity: trends and determinants.

Projections of a physician surplus for the 1990s have assumed that physician productivity will be constant at 1970s levels. Using the HCFA-NORC physician surveys of 1975, 1979, and 1984-85, this study examines trends in physician productivity over the past decade and estimates the impacts of physician and practice characteristics on current productivity. Visit productivity declined significantly between 1975 and 1984, suggesting that the projected surplus may be overstated. Cross-sectional results show that participation in alternative health plans is not associated with greater productivity, except for the higher work effort of independent practice association participants. The effects of physician time, nonphysician aides, and physician gender on productivity vary with alternative visit and revenues measures of productivity.