Characteristics of physicians in OEO neighborhood health centers.

This paper presents information about the characteristics of physicians working in neighborhood health centers funded by the Office of Economic Opportunity during the interval between inception of the OEO comprehensive health services programs in 1965 and January, 1971. The need for such information is evident from national policy proposals in the health care field which rest upon a series of assumptions about the physicians who will or should be expected to work in medical programs in poverty areas.1 Research objectives were: 1) to charac? terize "the OEO physician" using descrip? tors that could be readily gathered and replicated by future research and by poli? cy-makers and administrators in the field; and 2) to compare the OEO physicians and their community peers? physicians in the same community who are "at risk" of working in OEO programs but elect not to do so. Although the medical profession has been the subject of several sociological and ad? ministrative studies in recent years, the major focus of such studies often lies in the physician as prototype professional rather than as the target of policy. Several studies have examined the characteristics of physicians providing primary care in groups, notably their attitudes toward pa? tients or patient care,2 and the turnover patterns in their employment.3 Major na? tionwide surveys also have accumulated data concerning social and demographic descriptors of physicians in group prac? tices in general.4 The physicians most often studied represent prototype physicians, serving in the fee-for-service modality which predominates in this country. The physician working in non-fee-for-service group settings has not been extensively studied. Little concrete information is available about the physicians who elect to work in comprehensive health care programs in poverty neighborhoods. Similarly, little is known about the types of health care set? tings which seem to be able to attract and retain such physicians. In early testimony before Congress, OEO made it clear that its motivation in developing the neighbor? hood health center programs was to pro? vide comprehensive care of the highest quality, personalized and accessible to pov? erty populations. The programs were funded because of unavailability of satis? factory primary care in poverty areas to these populations.5 The programs of OEO evolved from an initial plan to contract into the existing health care system to a strategy to develop a prototype health care Hugh H. Tilson, M.D., Dr. P.H. is Assistant Pro? fessor, Department of Preventive Medicine and Public Health, University of Oregon School of Medicine, and Assistant County Health Officer, Multnomah County Oregon (104 S.W. 5th Avenue, Portland, Oregon 97204). This investigation was supported in part by PHS Training Grant # TO 1 HS 00003-08, from the National Center for Health Services Research and Development, HSMHA, and in part pursuant to a contract with the Office of Economic Opportun? ity, Executive Office of the President, through the Department of Health Services Administration, Harvard School of Public Health. The opinions expressed are those of the author and should not be construed as representing the opinions or policy of the United States Government. The author wishes to thank his doctoral program advisor, Alfred Yankauer, M.D., and the members of his thesis committee, Alonzo Yerby, M.D., Sidney Croog, Ph.D., and Jacob J. Feldman, Ph.D.