OBJECTIVES. Data from 509 primary care patients were analyzed to determine
whether practice style differences between family physicians and general in
ternists generate differential utilization of health care resources leading
to differential medical charges.
METHODS. New adult patients were prospectively randomized to care by family
physicians and general internists. Utilization of medical care services an
d associated charges then were monitored for 1 year of care.
RESULTS. Family practice patients had a significantly higher mean number of
visits to their primary care clinic and significantly fewer emergency room
visits than patients assigned to Internal Medicine. Mean charges for prima
ry care and emergency department treatment were significantly lower for pat
ients assigned to Family Practice than for those assigned to General Intern
al Medicine. There were no significant differences in charges for specialty
clinic visits, hospitalizations, or diagnostic services.
CONCLUSIONS. Practice style differences between family physicians and gener
al internists were associated with differential medical charges, with famil
y physicians generating lower charges for some aspects of care.