the who report - american academy of family …...the who report thirty-seventh in a series of...

A combination of American Family Physician’s “Who Are These Academy Doctors?” and

Family Practice Management’s “Practice Management Profile”

2016

THE WHO REPORT

Thirty-seventh in a series of surveys conducted by American Family Physician and Family Practice Management

2016 Who Report, American Academy of Family Physicians Page 1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Figure 1 . Current Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Figure 2 . Practice Arrangement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

WHO ARE THESE ACADEMY DOCTORS? Value of Medical Information Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Figure 3 . Value of Clinical Information Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Figure 4 . Most Important Sources for New Drug Information . . . . . . . . . . . . . . . . . . . . . . . . . 6 Figure 5 . Most Important Sources for Continuing Medical Education . . . . . . . . . . . . . . . . . . . 6

Clinical Journal Reading Habits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Figure 6 . Favorite Clinical Journals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Figure 7 . Time Frame for Reading Favorite Clinical Journal . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Table 1 . Most Important Reason for Reading Favorite Clinical Journal . . . . . . . . . . . . . . . . . . 8 Table 2 . Favorite Clinical Journals and Average Reading Times in Hours . . . . . . . . . . . . . . . . 8 Figure 8 . Average Time Spent Reading Journals by Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Figure 9 . Media Used for Reading AFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Table 3 . Favorite Clinical Journals and Average Reading Times in Hours . . . . . . . . . . . . . . . . 9

Prescribing Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Table 4 . Patient Categories Seen During Typical Two-Day Period . . . . . . . . . . . . . . . . . . . . . 10 Figure 10 . Prescriptions Written in Average Week . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Figure 11 . Three-Year Trend in Number of Prescriptions Written . . . . . . . . . . . . . . . . . . . . . . . 10

PRACTICE MANAGEMENT PROFILE Practice Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Practice Management Information Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Figure 12 . Value of Practice Management Information Sources . . . . . . . . . . . . . . . . . . . . . . . . . 11 Figure 13 . Most Important Sources for Practice Management Information . . . . . . . . . . . . . . . . 12

Practice Management Journal Reading Habits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Figure 14 . Three-Year Trend in Total Reading Time for all Practice Management Articles . . . . . 12 Figure 15 . Time Frame Within Which Favorite Practice Management Journal Is Read . . . . . . . 12 Table 5 . Most Important Reasons for Reading Favorite Practice Management Journal . . . . . . 13 Table 6 . First Favorite Practice Management Journals and Average Reading Times . . . . . . . . 13 Table 7 . Favorite Practice Management Journals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Table 8 . Favorite Practice Management Journals and Average Reading Times . . . . . . . . . . . . 14

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Contents

2016 Who Report, American Academy of Family Physicians


Thirty-nine years ago, the American Academy of Family Physicians (AAFP) made a commitment to providing

market research on its members that would assist health care marketers in targeting family physicians . Over the years, the type of data presented has slightly changed, but one thing remains constant—the desire to provide insight into the behavior of family physicians .

This research represents the 37th consecutive survey conducted by the AAFP on journal reading habits and member practice patterns .

As one of the largest medical specialty organizations (124,900 members), the AAFP is recognized as the nation’s top advocate for family medicine .

Family physicians treat the whole person within the context of family and community:

◆ Regardless of age, sex, or disease entity,

◆ In outpatient and hospital settings,

◆ With a wide range of surgical and diagnostic procedures,

◆ Referring fewer patients than any other specialty .

■ Office visits to family physicians represent about 21% of all patient visits,1 although family physicians represent only 13% of all physicians.2

■ Family physicians write 25% of all prescriptions issued during office visits, more than any other specialty.1

Family medicine is recognized as a specialty that is essential to managed care . The broad scope of family medicine helps reduce excessive costs and increases access to health care . Family physicians are the most commonly designated primary care providers, or “coordinator of care,” for managed care organizations (MCOs) .

With the importance of family physicians in the marketplace, savvy health care marketers target to this key specialty . Accordingly, the AAFP has undertaken to provide critical information on its physician members to assist in targeting and reaching family physicians .

Methodology The survey was developed by the Journal Media staff to measure the use of journals and practice characteristics of AAFP active members . The survey was administered to a randomly selected sample of approximately 4,000 AAFP active members . The survey invitations were sent by mail and email . All sample recipients received a mailed invitation, describing the project, a copy of the survey, and a link to complete the survey online . The sample recipients were also emailed a short explanation of the project, notification that a copy of the survey was being mailed, and a link to complete the survey online . Additional emailed communications were sent to non-responders through the data collection period .

One hundred sixty-one surveys were returned as a result of the mailing . One hundred five surveys were completed online . After removing duplicate respondents, a total of 266 usable surveys were used in the final analysis, which is a 6 .7% response rate . The number of sample respondents resulted in a margin of error of 5 .8% at the 95% confidence interval .

As in the previous 36 studies, no incentive, prompting, or assistance was offered . Any degree of bias, either implied or inherent, is associated solely with the fact that the survey was conducted by the AAFP for its members .

Introduction

1 National Ambulatory Medical Care Survey, 2012 .

2 2014 Physician Specialty Data Book-2013 data .


The average physician respondent:

◆ Is an office-based physician (see Figure 1) .

◆ Is most likely to be in a single-specialty small group setting (see Figure 2) .

Demographics

Figure 1 — Current Position

Figure 2 — Practice Arrangement

Other 9%

Residency/Med School Faculty

11%

Hospital-Based Physician

6%

Ambulatory Urgent Care

Physician 6%

Office-Based Physician 65%

Solo 16%

Large Practice (>10)14%

Small Practice (2-10)70%

Administrator3%


Physicians were asked to rate the value of listed medical information sources on a scale of very important to not important . Journals, continuing medical education (CME), colleagues, Internet/websites, and medical meetings received the highest percentage of importance (see Figure 3) .

Physicians were asked to state the three most important medical information sources for information on new drugs approved by the FDA, in rank order . Figure 4 details how these sources

were viewed in terms of primary, secondary, and tertiary importance for new drug information . Medical journals, Internet/websites, and references were the top sources .

Physicians were asked to state the three most important medical information sources for CME, in rank order . Figure 5 details how these sources were viewed in terms of primary, secondary, and tertiary importance for CME . Journals and CME medical courses were clear favorites .

Value of Medical Information Sources

Figure 3 — Value of Clinical Information Sources*

*Response rating of important and very important.

92%

78%

65%

61%

61%

43%

37%

21%

13%

6%

3%

Medical journals

CME courses

Colleagues

Internet/Websites

Medical meetings

References

Webinars

CD-ROM/Computer instructions

Pharmaceutical representatives

Direct mail by drug companies

Other


Value of Medical Information Sources, continued

Figure 5 — Most Important Sources for Continuing Medical Education

Figure 4 — Most Important Sources for New Drug Information

Medical journals

Pharmaceutical representatives

References

CME courses

Medical meetings

Internet/Websites

Colleagues

Direct mail by drug companies

Medical journals

CME courses

Medical meetings

References

Pharmaceutical reps

Internet/Websites

Colleagues

Direct mail for drug companies

CD-ROM/computer instruction

Other

Webinars/Webcasts

0% 10% 20% 30% 40% 50% 60%

0% 10% 20% 30% 40% 50% 60% 70%

Number and Reading TimePhysicians must make choices regarding which journals they will read, scan, and disregard . The reading patterns of AAFP members, therefore, shed interesting light on what family physicians read and how they read it .

Physicians were asked the number of medical journals they receive each month .

■ Family physicians indicate they receive an average of five journals each month.

■ Of those journals physicians stated they receive, only two are regularly read.

■ An average of 4.3 hours per month is spent reading medical journals.

■ Ninety-five percent of family physicians listed AFP as one of their top favorite journals (see Figure 6).

■ Sixty-two percent of family physicians read their favorite clinical journal within two weeks of receiving it (see Figure 7).

■ Eighty percent of family physicians listed AFP as their favorite medical journal.


Clinical Journal Reading Habits

Figure 6 — Favorite Clinical Journals

Figure 7 — Time Frame for Reading Favorite Clinical Journal

Within one week30%

Within two weeks32%

After two weeks38%

95%

27%

15%

12%

12%

9%

AFP

JAMA

NEJM

JFP

FPM

Consultant

Most Important Reason for Reading Favorite Clinical JournalWhen asked to choose one of five reasons as the most important reason for reading their favorite clinical journal, 73% chose “keep current in clinical practice” (see Table 1) .

■ Fourteen percent of family physicians who listed American Family Physician as a favorite journal believe that CME is the most important reason for reading it.

Favorite Clinical JournalsReading patterns emphasize the importance of identifying those journals that are most important to family physicians . Respondents were asked to write in the names of their three favorite clinical journals in priority order and to estimate the amount of reading time they allocate to each issue .

■ American Family Physician continues to be the favorite clinical journal (see Table 2).

The high rate of mention and reading time may be attributed to the commitment of AAFP members to what they view as “their” clinical journal .

During the five hours family physicians spend each month reading medical journals, they spend an average of: ◆ Two hours with their favorite clinical journal ◆ One hour with their second favorite ◆ One hour with their third favorite

Table 3 contains complete details on favorite clinical journals and average reading times, and is ranked by the total of mentions for the journals .

Journals listed in Tables 2 and 3 are the result of unaided recall . No assistance or prompting was provided, and the questionnaire did not identify American Family Physician in any way .

*

Page 8 2016 Who Report, American Academy of Family Physicians

Clinical Journal Reading Habits, continued

Table 1. Most Important Reason for Reading Favorite Medical Journal

Table 2. Favorite Clinical Journals and Average Reading Times in Hours

Useful in/for: All Respondents (%)

AFP is "Favorite" (%)

Clinical Practice 73 71

CME 16 19

Teaching 7 6

Medical News 4 4

Other 1 0

Useful in/for: First Mentioned

Avg hours per issue

American Family Physician 225 2

Journal of the American Medical Association (JAMA)

65 0.8

New England Journal of Medicine 36 0.9

Family Practice Management 29 0.8

Journal of Family Practice 27 1.1

Consultant 21 0.6

Prescriber's Letter 15 1.1

Medical Economics 12 1.1

The Medical Letter 9 1

Figure 8 — Average Time Spent Reading Journals by Media

Tablet/iPad6%

Smartphone7%

Laptop/Desktop

17%

Print71%

Figure 9 — Media Used for Reading AFP*

82%

13%

48%

10%

Print Online Tablet Mobile Device

*Respondents could select all methods used


Clinical Journal Reading Habits, continued

Table 3. Favorite Clinical Journals and Average Reading Times in Hours

Favorite 2nd Favorite 3rd Favorite Top 3 Favorites

Avg Hours Count Avg Hours Count Avg Hours Count Avg Hours Count

American Family Physician 2.1 185 1.4 22 1.5 18 2 225

Journal of the American Medical Association (JAMA) 2.5 7 0.6 40 0.7 18 0.8 65

New England Journal of Medicine 1.5 7 0.9 12 0.6 18 0.9 37

Family Practice Management 0.8 2 0.7 23 1.6 4 0.8 29

Journal of Family Practice 3 3 0.8 19 1.1 6 1.1 27

Consultant 0.4 2 0.6 10 0.8 9 0.6 21

Prescriber's Letter 1.4 7 0.9 5 0.8 3 1.1 15

Medical Economics 1 1 0.8 7 0.8 4 1.1 12

The Medical Letter 1.4 2 0.8 2 0.9 4 1 9

American Geriatrics Society * * 0.7 4 0.9 4 0.8 8

Journal Watch 4.1 4 1.1 3 0.5 2 2.3 8

Family Practice News * * 1 2 0.4 4 0.6 5

Annals of Internal Medicine * 2 0.5 1 0.3 2 0.2 4

British Journal of Sports Medicine * * 0.3 2 0.6 2 0.5 4

Journal of Urgent Care Medicine * * 0.8 3 0.1 1 0.6 4

Sports Medicine: A Multidisciplinary Approach 2.5 3 3.8 1 * * 2.9 4

UpToDate 1 1 * 1 0.2 2 0.3 4

Family Medicine * * * * 0.6 3 0.6 3

American Journal of Preventative Medicine * * 1 1 1 1 1 2

Annals of Family Medicine * * 0.5 1 1 1 0.7 2

Health Affairs * * 1.5 2 1 * 1.5 2

Journal of Medical Ethics * * * 2 * * * 2

Journal of Pain and Symptom Management 0.4 2 * * * * 0.4 2

Positively Aware * * * * 0.5 2 0.5 2

The American Journal of Sports Medicine 2.1 2 * * * * 2.1 2

The Journal of the American Board of Family Medicine * * 0.3 1 0.5 1 0.4 2

Analgesia and Anesthesia * * * 1 * * * 1

Anesthesiology * * * * 1 1 1 1

Audio-Digest * * 4 1 * * 4 1

British Medical Journal * * 0.2 1 * * 0.2 1

Consultant 360 * * * * 0.5 1 0.5 1

Contraception 3 1 * * * * 3 1

Journal of Addiction Medicine * * 0.5 1 * * 0.5 1

Journal of the American College of Emergency Physicians * * * * 1 1 1 1

Journal of the American Osteopathic Association * * * 1 * * * 1

Lancet * * * * 1.5 1 1.5 1

Medscape * * * * 1 1 1 1

Obstetrics and Gynecology * * * * 0.5 1 0.5 1

Patient Safety and Quality * * * * 0.5 1 0.5 1

Society of Hospital Medicine * * * * 2 1 2 1

Texas Family Physician Journal * * * 1 * * 0.3 1

Texas Medical Association Journal * * * * 0.3 1 0.3 1

*Not mentioned or no time specified


Table 4 illustrates the breadth of care offered by family physicians by noting the percent of family physicians who treat patients in selected categories during a typical two-day period .

In a normal week, the average office-based physician: ◆ Writes 114 prescriptions (see Figure 10) . ◆ Is writing the same number or more

prescriptions (see Figure 11) . ◆ Spends 45 minutes with pharmaceutical

representatives .

The 42% who do see pharmaceutical representatives average 4 .7 visits per week .

Table 4. Patient Categories Seen During Typical Two-Day Period

Prescribing Patterns

Hypertension 88%

Emotional Problems 83%

Cough/Cold 82%

Respiratory Infection 77%

Arthritis 73%

Reflux Disease/Heartburn 71%

Gynecologic Problem 67%

Adult Vaccinations 66%

Diabetes 63%

Asthma 62%

Osteoporosis 58%

Fibromayalgia 58%

Prostate Problem 55%

Well-baby Visit 54%

Menopause 54%

Sick Child (age 2 to 12) 54%

Obesity 53%

Ulcer 53%

Child Vaccinations 52%

Urinary Tract Infection 50%

Cholestrol Problem 46%

Constipation 46%

Dermatologic Problem 46%

Shingles 45%

Colorectal Problem 45%

Headache 45%

Severe Pain 45%

Allergies 42%

Sick Baby (age two or less) 41%

COPD 38%

Otitis Media 37%

Alzheimer’s/Dementia 36%

Cardiac Problem 36%

Birth Control 34%

Parkinson’s 31%

Sports Injury 22%

Figure 10 — Prescriptions Written in Average Week

200+17%

100-19925%

0-4935%

50-9923%

Figure 11 — Three-Year Trend in Number of Prescriptions Written

Increased29%

Stayed the Same58%

Decreased14%


In a normal week, the typical office-based physician:

◆ Spends nearly 42 hours in medical practice .

◆ Spends an average of five hours in practice management activities .

◆ Has diverse practice management responsibilities besides caring for patients, such as coding/reimbursement, clinical quality improvement, supervising nurses and office staff, administrative functions, and working on patient satisfaction .

◆ Uses a computer and the Internet in the office and at home .

◆ Uses the Internet for diverse functions, such as looking up clinical information, CME courses, searching for journal articles, and looking up practice management information .

◆ Works on practice marketing, collecting and analyzing practice data .

Practice Patterns

Physicians were asked to rate the value of listed practice management sources on a scale from very important to not important . Colleagues and practice management journals received the highest percentages (see Figure 12) .

Physicians were asked to name the top-three practice management information sources in rank order of importance to their practices . Practice management journals received the most “primary importance” mentions (see Figure 13) . Other important sources include colleagues, practice management articles, and office managers .

Practice Management Information Sources

Figure 12 — Value of Practice Management Information Sources*

20%

10%

19%21%

26%

29%

35%

44%46%

34%

46%

MCOsPractice management consultants

Hospital programs

OtherInternet/ websites

Practice management

courses

Medical associations

Office manager

Articles in general medical journals

Colleagues Practice management

journals

*Response ranking of important and very important.


Practice Management Information Sources, continued

Figure 14 — Three-Year Trend in Total Reading Time for all Practice Management Articles

Decreased 33%

Stayed the same51%

Increased16%

Figure 15 — Time Frame Within Which Favorite Practice Management Journal Is Read

Within one week24%

After two weeks48%

Within two weeks29%

Practice Management Journal Reading Habits

Figure 13 — Most Important Sources for Practice Management Information

Practice management journals

Colleagues

Medical associations

Articles in general medical journals

Office manager

Practice management courses

Internet/Websites

Hospital programs

MCOs

Practice management consultants

Other

42%

39%

38%

36%

25%

22%

18%

13%

7%

21%

16%


Each month, the average family physician:

◆ Spends 4 .3 hours reading medical journals . ◆ Spends more than 45 minutes reading

practice management articles .

■ Physicians who regularly read Family Practice Management are more likely to have maintained or increased their practice management reading (75%).

■ At the same time, 84% have decreased or kept total reading time stable over the past three years (see Figure 14).

◆ This is indicative of a shift in reading patterns to a higher mix of practice management reading .

■ More than one-half (53%) of family physicians read their favorite practice management journal within two weeks of its receipt (see Figure 15).

■ The most important reasons for reading the favorite practice management journal are to pick up tips for practice operation (13%) and to keep current on issues important to family physicians (44%) (see Table 5).

Respondents were asked to write in the names of their three favorite journals in priority order, and to estimate the amount of reading time allocated to each issue (see Table 6) .

■ Family Practice Management continues to be the favorite practice management journal .

Tables 7 and 8 contain complete details on favorite journals and average reading times . Journals are ranked by the total number of mentions for first, second, and third favorite journals .

Practice Management Journal Reading Habits, continued

Table 5. Most Important Reasons for Reading Favorite Practice Management Journal

All responses

FPM is regularly read

Keep Current on FP Issues 44% 41%

Tips for Practice Operations 13% 18%

Medicare/Insurance Changes 12% 15%

Enhance Non-clinical Skills 10% 10%

Earn CME 8% 7%

Time/Stress Management Techniques

3% 2%

Handling Personal Finances 1% 1%

Overhead Cutting Tips 1% 1%

Other 7% 5%

Table 6. First Favorite Practice Management Journals and Average Reading Times

First mentioned

Avg. hours per issue

Family Practice Management 97 0.7

Medical Economics 20 0.6

American Family Physician 6 N/A


3 0.6

Society of Homeopathic Medicine

2 0.5

Physician Executive Journal 1 0.3


Practice Management Journal Reading Habits, continued

Table 7. Favorite Practice Management Journals

Table 8. Favorite Practice Management Journals and Average Reading Times

Favorite 2nd Favorite 3rd Favorite Total

Family Practice Management 61% 26% 11% 65%

Medical Economics 12% 30% 9% 20%

American Family Physician 4% 10% 19% 5%

Favorite 2nd Favorite 3rd Favorite Top 3 Favorites

Avg Hours Count Avg Hours Count Avg Hours Count Avg Hours Count

Family Practice Management 0.7 97 0.4 10 0.2 1 0.7 108

Medical Economics 0.6 20 0.4 11 1 1 0.5 32

American Family Physician * 6 0.7 4 * 2 0.7 12


0.6 3 * * * * 0.6 3

Practice Link * * * 2 * * * 2

Society of Hospital Medicine 0.5 2 * * * * 0.5 2

AAFP News 1 1 * * * * 1.3 1

Family Practice News * * * 1 * * * 1

Health Affairs * * 0.5 1 * * 0.5 1

Journal of Medical Practice Management * * * * 0.3 1 0.3 1

Journal Watch * * * 1 * * * 1

Physicians Practice * * * * 0.3 1 0.3 1

* Not mentioned or no time specified


Conclusion

Family physicians are a key specialty for health care marketers because they have a pivotal role in managing overall patient care for an

increasing number of patients . And,

◆ There are more office visits to family physicians than to any other specialty (21% of all office visits) .1

◆ Family physicians write 25% of all prescriptions issued during office visits,1 and

◆ Family physicians write 114 prescriptions in an average week .

When targeting the family physician, American Family Physician is the journal of choice . Back issues are saved and read thoroughly . This is evidenced by more than 500,000 quizzes returned each year .2

American Family Physician (AFP) and Family Practice Management (FPM ): Meeting the clinical and practice management needs of the family physician.

AFP is the family physician’s favorite clinical journal (see Table 3) . It’s read cover-to-cover more than any other journal and ranked number one in ad exposures .3

Family physicians continue to be a critical target audience in the medical/surgical market . As the journal that best meets the needs of family physicians, AFP provides maximum exposure to this target audience . The AAFP’s commitment to understanding and fulfilling the evolving needs of family physicians is a strong guarantee of the ability of AFP to be a foundation media buy—now and in the future .

FPM helps family physicians find a way to provide quality patient care that is also cost-effective . Most family medicine practices function like the average small business . There is a need for competence in payroll, accounting, personnel policies, marketing, billing, collections, contract negotiation, and recordkeeping—all while satisfying the needs of multiple insurance companies, federal programs, state programs, and patients .

No wonder there is a need for practice management information that is specific to the specialty of family medicine . And, no wonder family physicians are reading FPM for the answers to practice management .

The solution?

When targeting family physicians in your media plan, American Family Physician is the journal of choice! And, adding Family Practice Management to a media schedule helps build a solid specialty foundation for your plan .

1 National Ambulatory Medical Care Survey, 2012, Table 24 .2 Quiz Returns, American Academy of Family Physicians, Leawood,

KS, 2015 .3 Kantar Media, Medical/Surgical Study, Tables 102 and 108, June

2016 .


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