TEACHING MEDICAL-STUDENTS IN COMMUNITY-BASED PRACTICES - A NATIONAL SURVEY OF GENERALIST PHYSICIANS

BACKGROUND. This study was undertaken to determine the extent of medic al student teaching by community-based generalists, differences betwee n teachers and nonteachers, and physicians' perceptions and attitudes about teaching. METHODS. Two questionnaires were mailed to a random sa mple of 4974 generalist physicians in community-based practice in the United States including family physicians, general internists, and gen eral pediatricians. The first survey instrument was a postcard with tw o questions; the second was a 4-page questionnaire sent to postcard re sponders. These mailings were supplemented by a telephone survey of no nresponders. RESULTS. Forty-two percent. responded to the postcard, an d, of those, 47% responded to the questionnaire. Adjusted by the resul ts of a telephone survey of postcard nonresponders, 30% of family phys icians and general pediatricians and 20% of general internists taught medical students in their offices. The average teaching physician work ed with three students per year for approximately 10 days each. Family physicians and general internists who had community-based educational experiences while in medical school were more likely to be teachers. Teachers were somewhat younger than nonteachers (year of medical schoo l graduation 1977 vs 1973), but there were few other differences. Cont rolling for specialty, teachers did not differ from nonteachers in pat ient-care volume or payer mix of the practice. Teachers noted a 30-min ute (median) lengthening of their workday when a student was present, and 30% saw fewer patients per day when a student was in the practice. Only 9% of the teachers reported being paid for their teaching. More than 90% of both nonteachers and teachers believed that students shoul d receive part of their education in community-based practices.CONCLUS IONS. Depending on specialty, 20% to 30% of community-based generalist s teach medical students. Although teachers perceive that teaching len gthens their work day and may decrease productivity, the great majorit y of both teachers and nonteachers believe that community-based educat ion is important.