Group Practice Affiliation and Interphysician Consulting Patterns within a Community General Hospital

Much of the research on informal practice relationships among physicians is based upon observations of physicians in solo, fee-for-service forms of practice. This study examines informal relationships for physicians in group practice. Specifically, this study analyzes the within-hospital consulting patterns of physicians in two group practices, one fee-for-service and the other prepaid. Compared with the fee-for-service-group physicians, the prepaid-group physicians (1) engaged in less consulting, (2) utilized nongroup consultants to a greater degree, (3) relied more heavily on medical residents as consultants, and (4) achieved a lower degree of reciprocity in consulting exchange. Physicians in both of the groups exhibited a pattern of mutual avoidance in the choice of consulting partners.