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FROM VITA~& HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE � Public Health Service I Nwnber39 s September 7,1978 

Office Visits to Urologists, National Ambulatory 

Medical Care Survey: United States, 1975-761 

Using data from the National Ambulatory 

Medical Care Survey (NAMCS), this report 

describes an estimated 20,728,000 visits made to 

the offices of urologists over the 2-year span 

from January 1975 through December 1976. 

NAMCS is a sample survey designed to explore 

the provision and utilization of ambulatory care 

in the physician’s office-the setting where most 

Americans seek health care. The survey is conduct ed yeady throughout the coteminous 

United States by the Division of Health Resources Utilization Statistics of the NationaI 

Center for HeaIth Statistics. The survey sample 

is selected from doctors of medicine and osteopathy who are principally engaged in officebased, patient-care practice. Excluded from the 

sample are an indeterminate number of physicians who render some office-based ambulatory 

care but whose patient-care activities are secondary to another primary role such as teaching, 

research, or administration. AIso excIuded from 

the NAMCS scope are physicians who are hospital based; those whose specialty is anesthesiology, pathology, or radiology; and physicians 

in Federal service. 

Since the estimates presented in this report 

are based on a sample rather than the entire universe of office-based, patient-care physicians, 

they are subject to sampling variability. Technical Notes, which foIlow this text, explain this 

and present guidelines for judging the relative 

precision of estimates in this publication. The 

directions offered there also provide the basis 

. 

1This report was prepared by Hugo Koch, Division of 

Health Resources Utilization Statistics. 

for judging the statistical significance of differences between estimates. 

DATA HIGHLIGHTS 

With their estimated 20,728,000 office visits 

in the 2-year span 1975-76, urologists were 

among the 13 types of specialists who figured 

most prominently in the provision of officebased ambulatory care (table 1). 

Compared with the entire universe of officebased physicians, the overall preference for solo 

practices over multipIe-member was reversed for 

urologists (table 2); more than half of the visits 

(57 percent) were made to physicians in 

multiple-member arrangements, a preference 

Table 1. Number of office visits to the 13 most-visited specialists, 

by typa of specialty in rank order: United States, 1975-76 

Number of 

Rank Type of specialty visits in 

thousands 

General and family practice . ................. 460,297 

Internal medicine ................. ............ ..... 130,367 

Pediatrics .... ..................................... ...... 107,085 

Obstetrics and gynecology .............. ....... 97,070 

General surgery ............. ........ ................ 77,259 

Ophthalmology ................................. .... 53,959 

Orthopedic surgery .......... ........... ........... 47,152 

Dermatology ................................. ........ 35,721 

PsychiatW ............ ................................. 30,616 

~olawngology ............. ........................ 27,192 

molofl ................................................. 20,728 

Card iovascu Iar disease .................... ....... 13,517 

Neurology ................................ ............. 3,784 
2 4 

— 

Table 2. Nurrber and percent distribution of office visits to 

urologists and percent distribution of office visits to all 

‘specialists by location and type of practice: United States, 

1975-76 

Visits to- Number of 

Location and type visits to All of practice urologists Urologists 

in thousends specialists 

Percent distribution 

All visits .......... 20,728 100.0 %00.0 

Location of practice 

t 

Metropolitan areez .. .... .. .. 16,871 81.4 73.3 

Nonmetropolitan area .. .. . 3,857 18.6 26.7 

Type of practice 

solo .... . ... .. .. .. ..... ... ... ... .. .. . 8,887 

Other............................... 11,841 

lBased on an estimated 1.155.900.000 viaits made to all 

office-based physicians in 1975 and 19’76. 

2Within a standard metropolitan statistical area (SMSA). 

Composition of SMSA’S does not reflect 1974 adjustments. 

shared by four others among the most-visited 

specialists: pediatricians, obstetricians and 

gynecologists, orthopedic surgeons, and otolaryngologists. 

A majority (60 percent) of visits to urologists were made by patients over 44 years of 

age (table 3). The median visit age (i.e., the age 

calculated from the distribution of visits rather 

than individual patients) was about 47 years, exceeding by 10 years the national median of 37 

years calculated from visits to all office-based 

physicians. An estimated 60 percent of visits to 

urologists were made by male patients (table 3), 

a proportion that substantially exceeded the 

average proportion of male visits found in overall office-based practice (40 percent). Indeed, 

urology is one of the few specialties where visits 

by males equaled or exceeded visits by females, 

the other notable exceptions being pediatrics, 

orthopedic surgery, and cardiovascular disease. 

The 19.8 percent of visits to urologists made 

by new patients is relatively high compared 

with the corresponding 14.6 percent found 

in overall office-based practice (table 3). Contributing in a large degree to this increased 

presence of new patients is the finding that 2 of 

Table 3. Number and percent diatrib.ution of office visits to 

urologists and percent distribution of office visits to all 

srxcialiats by selected characteristics of the patient: United 

States, 197&76 

Visits to- Number of 

visits to Patient characteristic All - urologists Jrologiats specialists in thousends 

r 

Percent distribution 

\ 

All visits ........... 20,728 100.0 1100.0 

Aae 

Under 15 years ................. 1,504 d7.3 18.1 

15-24 years ....................... 1,539 7.4 15.1 

26-44 years ....................... 5,22$ 25.2 25.5 

45-64 years ...................... 6,587 31.8 25.1 

65 years and over ............. 5,870 28.3 16.2 

— 

sex 

Female . ... .. ... ... . ... . .. .. .. . . .... 8,404 40.5 60.4 

Male . .... ... . ... .. .. .... . .. ... .. .. .. . 12,324 59.5 39.6 

Prior visit status 

New patient . . .. .... . . .. .. .. .... . 4,109 19.8 14.6 

Old patient:. 

New problem .. . ... . .. .... 1,670 8.1 23.2 

Old problem ... . ... .. .. ... . 14,949 72.1 62.3 

18ased on an estimated 1,155,900,000 v~lts made to all 

office-based physicians in 1975 and 1976. 

every 5 of these visits by new patients were 

referrals from other physicians or agencies. This 

referral rate (8.4 percent of all the urologists’ 

visits) is more than triple the average rate of 2.6 

percent found for all office-based physicians. It 

is exceeded by only one other of the most-visited 

specialties—neurology. For the 5,779,000 visits 

at which a new problem was presented to the 

urologist (i.e., the 4,109,000 visits by new 

patients plus the 1,670,000 visits by old patients 

with new problems), there were 14,949,000 

return visits, an average of 2.6 return visits per 

new problem per year, a rate considerably higher 

than the average of 1.6 return visits found in 

overall office practice. Indeed, it was exceeded 

by only two others among the most-visited 

specialties-psychiatry and cardiovascular disease. 

Ten complaints or symptoms accounted for 

3 of every 5 visits to the urologist (table 4). The 

I 
— 

admcdaa3 

Table 4. 

I 

I 

Rank 

1


2 

3 

4 

5 

6 

7 

8 

9 

10 

1 ~sed 

Number, percent, and cumulative percent 

expressed by patients classified by 

tvksst common complaint or 

Symptoms referable to urinary tract NEC2 

(includes bladder trouble, passed stones) 

of office visits to urologists, by the 10 most common complaints or symptoms 

NAMCS code and ranked by number of visits: United States, 1975-76 

I 

I Visits to urologists 

symptom and NAMCS codel 

Number in Cumulative Percent thousands percent r 

.. ...................................... ...... ............62O 2,541 12.3 12.3 

painful urination .. . .. ... ... .. . ... .. . ... . .. .... . . ... .. . ... . . .... . ... . ... . ... .. . .... . . .... .. .... .. ... .. ... . .. ... ...6W 2,211 10.7 23.0 

Frequency and nocturia . . . .. .. . .. .. . . ... .. .. ... ... ... . . .... . .. .. ... .. .. .. . .... . .. .. .. . ... . ... .. .. . .. ... .. . ..fiol 1.936 9.3 32.3 

Symptoms referable to the male reproductive system other than male 

infertility, psychosexual problems, and pain, swelling, or mass of male 

genital system ... . .. .... .. .... . . .... ... .. . .. ... .. .. .. .. . ... .. . .... . . ... .. ..... .. ... . .. ... ... .... .. . .. ... . .... . . ..6N 1,159 5.6 37.9 

Painr swelling or mass of male genital system .. .. .. . . ..... . . .... ... .. . . ... .. .... . .. . ..... . .... .. ...63l 1,147 5.5 43.4 

Abdominal pain . .. .. .. .. .. ... . ... . ... . .. .. ... . .. . .. .. .. .. .... . . ... .. ..... . . ... . ... .. . .. . .. ... .... . . ... ... .. .. . ...54o 830 4.0 47.4 

Urine abnormalities and abnormal constituents . .... . . .... . .. .. .. .. .. . .. .. ... . .. .... . .. ... .... . .. . m 805 3.9 51.3 

Other urinary dysfunction (includes hesitancy, large volume, slowing 

of Wrmm) .. . .. ... . .. ... .. . ... .. . ... . .. .. ... ... .. .. .. ... .. .. .. .. . .. ... .. .. . .. .. .. .. .. .. .. . .... .. . ... .. . ... . . .... ...61 O 714 3.4 54.7 

Incontinence of urine . .... .. ... . . .... . . .. .. . ... .. .. ... . ... .. .. . .. . ... . .. .. .. .. . . .. ... . .. .. . ... ... . .... ... .. ...6O2 657 3.2 57.9 

Pain, swelling, injury of back region . . ... . .. ... .. . .... ... .. .. . ... .. . ... .. .. .. . . .. .. .. .... . .. ... .... .. ..4l5 565 2.7 60.6 

on ~ symptom clarification develoDedfor use ~ N~CS-

@ 

c 

2Not el~where ;Iassified. 

terrrs and codes applied to these compkints or 

symptoms come from a symptom classification 

developed for use in the National Ambulatory 

Medical Care Survey.z 

Of the complaints that patients presented to 

urologists, the majority (about 60 percent) 

signaled chronic conditions, i.e., preexisting conditions with an onset of 3 months or more 

before the visit. Although most of the visits for 

chronic conditions reflected a routine (maintenance) type of care, a relatively large proportion (two-fifths) were caused by a flareup of 

the condition, bringing to the uroIogist’s office 

practice much the same aspect of cliniczd immediacy found among specialties such as general 

practice and pediatrics, where the emphasis is on 

acute morbidity-conditions with more recent 

onset and a more demanding and felt need for 

speedy attention. 

Table 5 presents data on the 10 principal 

diagnoses most frequently rendered by the 

2Nati~n~ Center for Health Statistics: The National 

Ambulatory Medical Care Survey, Symptom .Qassification, by Sue Meads and Thomas McLemore. Vital and 

Health Statistics. Series 2-No. 63. DHEW Pub. No. 

(HRA) 74-1337. HeaIth Resources Administration. 

Washington. U.S. Government Printing Office, May 

1974. 

office-based urologist. The principaI diagnosis 

was the first-listed- diagnosis ‘on a-survey-form 

that permits up to three diagnostic entries. 

Table 6 classifies zdl principal diagnoses 

made by urologists into major diagnostic groups. 

Diagnostic classes and codes are those established by the Eighth Revision International 

Classification of Diseases, Adapted for Use in 

the United States (ICDA). One diagnostic finding distinctive to the urologist’s office practice is 

the relatively high frequency of neoplasms 

encountered there. Among the most-visited 

specialists (tabIe 1), this frequency is exceeded 

by only two other specialists-dermatologists 

and general surgeons. 

To establish a diagnosis, office-based urologists-like most of their office-based counterparts-placed focal reliance on the limited history and examination (table 7), one limited to 

the body sites and systems specific to their 

scope of specialization, and concerned primarily 

with the patient’s chief comphint, painfud 

urination, frequency, nocturia, and so forth. 

Urologists used laboratory tests about 3 times as 

often as the average office-based specialist, and 

their use of endoscopy (in 8.3 percent of visits) 

exceeded the use of these procedures by any of 

the 12 other most-visited specialists. Perhaps 

meriting attention is the relatively infrequent 
1

2

3

4

5

6

4 

Table 5. Number, percent, and cumulative percent of office visits to urologists, by 10 principal diagnoses most frequently rendered 

classified by ICDA category and ranked by number of visits: United States, 1975-76 

Rank 

7 

8 

9 

10 

Most frequent diagnosis and ICDA code] 

Cystitis ...... ...... ...................................... ............... ..................................... ....... ..595 

Stricture of urethra ..................... ........................ ...............................................598 

Medical and surgical atier=re . .... ....................... ............................. .... .............. YI O 

ProWatitis ........................ ............... ............ .... .... .............................................. ..6Ol 

Hyperplasia of proXate ........ ........................................ ......................................6OO 

Other diseases of urinary tract (includes infection NEC2; urinary fiatulal; 

urethral caruncle, diverticulitis, diverticulosis, false passage, rupture; male 

urethrocele ..................................................................................599 .599. O.599.9 

Urethritis (nonvenereal) .. ........................... ...................... ..................................597 

Malignant neoplasm of pro~ate ............ .................................... ..........................l85 

Symptoms and illdefined conditions; symptoms referable to genitourinary 

system, e.g., pain, urinary system; retention and incontinence of urine; 

frequency of micturition; polyruia and oliguria; priapism and pain, 

genital organs ........................... ...................................... ..............786 .786. O.786.7 

Calculus of kidney and ureter ......................................... ..................................592 

Visits to urologists 

Number in Percent ;umulative 

thousends percent 

2,247 10.8 10.8 

2,075 10.0 20.8 

2,044 9.9 30.7 

1,927 9.3 40.0 

1,217 5.9 45.9 

1,200 5.8 51.7 

947 4.6 56.3 

720 3.5 59.8 

705 3.4 63.2 

608 2.9 66.1 

18ased on Er&hth Revision International Classification of Diseases, Adapted for Use in the United States (lCDA). 

2Not elsewhereclassified, 

number of occasions (about 14 percent of visits) 

at which a blood pressure reading was taken. 

Drug therapy- was the trea~ment most frequently provided by urologists (table 7); they 

used it in about 40 percent of visits, a proportion that was roughly paralleled in overall 

office-based practice. Their use of surgical procedures in the office (in about 19 percent of visits) 

substzuitially exceeded the average frequency of 

office surgery among all specialists.3 

Table 8 presents data on the severity of the 

problems that patients presented to the urologist, expressing the doctor’s judgment of the 

extent of impairment that might result if no care 

were available. In close parallel to the average 

tendency among all office-based practitioners, 

urologists judged most of their patients’ problems (4 of every 5) to range from slightly serious to not serious in prognosis. 

Directly reflecting the chronic nature of 

31n fie Nation~ Ambdatory Medical Care Survey, 

office surgery is defined as “any surgical procedure performed in the office this visit, including suture of 

wounds, reduction of fractures, application/removal of 

casts, incision and draining of abscesses, application of 

supportive materials for fractures and sprains, and all 

irrigations, aspirations, dilatations, and excisions. ” 

most problems presented to them, urologists 

ended’7 of every 10 visits by scheduling a return 

visit at a specified time (t~ble 8). Th~ 7.1 percent of visits that ended in hospital admission 

Table 6. Number and percent distribution of office visits to 

urologists by principal diagnoses classified by major ICDA 

group: United States, 1975-76 

Principal diagnosis 

and ICDA codesl 

Ail principal diagnoses ..... 

Neoplasms ......... .............. ....l4O-239 

Diseases of the genitourinary 

system .............. .................58O-629 

Symptoms and illdefined 

conditions, .. ......................78O-796 

Special conditions and examinations 

wikhout sickness (chiefly, surgical 

eftercare) ..... ....................YOO-YI 3 

Dther diagnoses classified chiefly 

in groups Accidents, poisonings, 

and violence and Infective and 

parasitic diseases ............... Residual 

Visits to urologists 

Number in Percent 

thousands distribution 

20,728 100.0 

1,329 6.4 

12,639 61.0 

1,813 8.8 

2,754 13.3 

2,193 10.5 

1 &sed on Eighth Re~i~.on Intermtional aassificatiors of 

Diseases, Adapted for Use in the United States (ICDA). 
---

dmcdata5 — 

Table 7. Number and percent of office visits to urologists and 

percent of offiie visits to all specialists, by typa of service 

provided: United States, 1975-76 

I 

Visits tO- Nurnbar of 

visits to Type of service provided All Sp& urologists Urologists ialistsl 

in thousands 

Table 8. Number and percent distribution of office visits to 

urologists and percent distribution of office visits to all 

special ists by selected visit characteristics United States, 

1975-76 

visits to- Numbar of 

visits to Visit characteristic 

urologists 

n thousands T 

Diagnostic service 

Limited history and . . exammation, ........ .......... 

General history and . . exammatlon ................... 

Clinical laboratory test.... 

x-ray ............................... 

Blood pressure check ...... 

Endoscopy ...................... 

Therapeutic service 

Drug prescribed ....... .... .... 

Injection .............. ........... 

Office surgery ................. 

Medical counseling .......... 

Other services ............ 

� lpercents based on an estimated 

h 

10~72IT 52.9 51.6 

2,758 13.3 16.3 

13,849 66.8 22.8 

1,819 8.8 7.6 

2,797 13.5 33.2 

1,727 8.3 1.2 

8,361 40.3 43.6 

552 2.7 13.1 

3,921 18.9 6.9 

1,881 9.6 13.0 

962 4.6 5.6 

All visits ........... 

Seriousness of problem 

Serious and very serious... 

Slightly serious ................ 

Not serious ...................... 

Disposition 

(selected actions)2 

No followup ........ ............. 

Return at specified time... 

Return if needed .............. 

Telephone followup ......... 

Referred to other 

physician or agency ........ 

Returned to referring 

physician ....................... 

Admit to hospital ............ 

Duration of visit3 

1-5 minutes ....... ............... 

6-10 minutes .................... 

11-15 minutes ... ............... 

1&30 minutes .................. 

31 minutes or more .... ...... 

Percent distribution 

20,728 100.0 1100.0 

4,105 19.8 19.2 

7,692 37.1 32.3 

8,931 43.1 48.5 

766 3.7 12.3 

14,600 70.4 60.2 

3,603 17.4 21.9 

491 2.4 3.5 

578 2.8 2.8 

!535 2.6 0.9 

1,481 7.1 2.1 

2,819 13.6 15.1 

6,000 28.0 31.5 

5,043 24.3 26.6 

5,763 27.8 19.5 

1,082 5.1 5.5 

1,155,900,000 visits made to 

all office-based physicians in 1975 and 1976. 

more than tripled the proportion (2. 1 percent) 

common in overall office-based practice. Indeed, 

it was the highest rate of hospital admission 

among all the 13 most-visited specialties. 

Data on duration of visit (table 8) reveal that 

the average face-to-face encounter between 

patient and office-based urologist lasted slightly 

more that 15 minutes; it did not differ substantially from the 15-minute average calculated 

for all office-based specialists. 

lBased on an esti~ted 1,155,9 N),CIIM tilts ~de ‘0 au 

office-based physicians in 1975 and 1976. 

2Figures wfi not add to totals because more than one disposition was possible. 

3Face.to.face encounter between physician and patient. 

SYMBOLS 

Data not available—–—————————— ———

Category not applicable——— . . . 

Quantity zero–-——— 

Quantity more than Obut less than 0.05———— 0.0 

o Figure does not meet standards of 

reliability or precision (more than 

* 30-percent relative standard error)— 
TECHNICAL NOTES 

SOURCE OF DATA: The information presented


in this report is based on data collected in the


Nat ional Ambulatory Medical Care Stuvey


(NAMCS) during 1975 and 1976. The target uni­


verse of the NAMCS is comprised of office visits


made within the coterminous United States by


ambulatory patients to non-Federal physicians


who are principally engaged in office practice


and are not in the specialties of anesthesiology,


pathology, or radiology. The National Opinion


Research Center, under contract to the National


Center for Health Statistics, was the organi­


zation responsible for the survey’s field oper­


ation.


SAMPLE DESIGN: The NAMCS utilizes a muki­


stage probability design that involves samples of


prim ar y sampling units (PSU’S), physic--km


practices within PSU’S and patient visits within


practices. Each year 

physicians is selected 

tained by the American 

American Osteopathic 

2-year period 1975-76, 

were included in the 

a sample of practicing 

from master fdes mainMedical Association and 

Association. (For the 

a total of 180 urologists 

sample. They achieved a 

response rate of 85 percent. ) Characteristics of


the physician’s practice, for example, primqr


specialty and type of practice, are obtained dur­


ing an induction interview. The physicians are


requested to complete Patient Records (brief


encounter forms) for a random sample of office


visits during a rando rnly assigned weekly report­


ing period.A (In the 2-year period 1975-76, sam­


pled urologists completed a total of 2,945 Patient


Records.) A detailed description of the NAMCS


design and procedures has been presented in an


earlier publication. s


SAMPLING ERRORS: Since the estimates for


this report are based on a sample rather than the


entire universe, they are subject to sampling vari-


4A facsimile of the Patient Record appeara as figure 

I. 

5 National Center for Health Statistics: The National 

Ambulatory Medical Care Survey, 1975 Summaty, 

United States, January-December 1975, by Hugo Koch 

and Thomas McLemore. vital and ~e~th s~~~jc~. 

Series 13-No. 33. DHEW Pub. No. (PHS) 78-1784. 

Public Health Service. Washington. U.S. Gowmment 

Printing Office, Jan. 1978. 

abilitv. The standard error is primarily a measure 

of sampling variability. The relative standard error of an estimate is obtained by dividing the 

standard error of the estimate by the estimate 

itself and is expressed as a percent of the estimate. Relative standard errors of selected aggregate statistics are shown in table I. The standard 

errors appropriate for the estimated percentages 

of the office visits are shown in table II. 

Table 1.Approximate relative standard error of estimated 

numbers of office visits, NAMCS 1975-76 

Estimate Relative standard 

in error in 

thousands percentage points 

600- .......................... ............. 30.2 

1,000 ....................................... 23.5 

2,000 .................... ................... 16.7 

4,000 . .................................... 12.0 

Io,ooo . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . .. . . 8.0 

40,000 .. . . . .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . 4.8 -

200,000 . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . 3.4 

1 ,Otx),ooo . . . . . . .. . . . . . . . . . . . . . .. .. . . . . . . 3.1 

Exampk of use of tabk: An aggregate estimate of 25,000,000 

visits bas a retativestandard error of 6.4 percent or a standard 

error of 1,600,000 visits (6.4 percent of 25,000,000). 

Table II. Approximate standard errors of percentagesfof 

estimated numbers of office visits, NAMCS 1975-76 

Baseof percentage Estimated percentage 

(number of visits 1 or 5 or 10or 20 or 30 Or in thousands) 99 95 90 80 70 50 

I Standard error in percentage points 

600 ... . ... .. .. ... .. . ... . ... 3.0 6.5 9.0 12.0 13.8 15.0 

1 mom .. .... .. .. .. .. .. .. .. 2.3 5.1 7.0 9.3 10.7 11.6 

2.000 ... ... .. .. ... .. .... .. 1.6 3.6 4.9 6.6 7.5 8.2 

4,000. . . .... .. . .... . .. 1.2 2.5 3.5 4.7 5.3 5.8 

Io,csoo- .. ... . .. ... . .... . 0.7 1.6 2.2 2.9 3.4 3.7 

40,000 .. .. ..... . .. ... ... . 0.4 0.8 1.1 1.5 1.7 1.8 

200,000 .... ... .. .. .. .. .. 0.2 0.4 0.5 0.7 0.8 0.8 

1 .Ooo,ooo .. .. .... .. .... 0.1 0.2 0.2 0.4 1

hmpfe of uaeof table An estimate of 20 

0.3 

percent 

0.3 

based on 

~ Wt?wmte estimateof 80 100,000 visits has a standard error of 1.3 percent. The retativest ldsrd error of 20 percent is 6.5 (1.3 

percent+ 20 percent). 

ROUNDING: Aggregate estimates of office visits ~ 

presented in the tables are rounded to the nearest 

thousand. The rates and percents, however, were 

calculated on the basis of original, unrounded 
7


Figure L PATlENT RECORD 

... ASSURANCE OF CONFIDENTl&lTY-YN i&tmuwm __m.. dm~ 

, rmct.. . �n ~ cOnR&ml wiElmn9d@bv P9pa3alm8srn-ld Fa 

tlw@xpcsmOEllw wlvwdwS Iwllmdkckaed .--c am-. d%rmvuh9r PuPm8. 

B~(? 

7.	 HAVE YOU EVER SEEN 

THIS PATIENT BEFORE ? 

!uYy ,CINO 

II YES. for the problem 

indicsted in /TEM 5a 7 

I � YES IONO 

~ VISIT 

ITEM 50 ENTRY 

DIAGNOSES 

12.	 OURATION OF 

~ VISIT ( rim 

actually spat witk 

physician) 

1.	 SFATEOF VISIT PATIENT RECORD 

NATIONAL AMBULATORY MEDICAL .~ 

2.	 DATE OF BIRTH 4. COLOR OR 5. PATIE~S PSNCIML PMSLEM(SI 

SACE COWSANIT(S). on STwsoml m = 

{/. #3Ekrs -s Iwms) 

.* ;: :;:., ~~ 

3.555 BLACK IMPORTANT 

t n FEMALE , � OTHER 

I � MALE s •l UNKNOWN b. OTHER 

CARE SURVEY 

6.	 SERIOUSNESS OF 

PAOM.EN ISI ITEN 5a 

(Check one) 

I D VERY SERIOUS 

I Cl SERIOUS 

, � SLIGHTLY SERIOUS 

. � NOT SERIOUS 

PNTSICIAN% PSNICIPAL OIAGFSOSFS 

a. OIAGNOSIS ASSOCIATED WITH 

b. OTHER SIGNIFICANT CURRENT 

(/. W* OF impcwtance) 

DISPOSITION THIS MST 

[Cbuk & tit 3$PM 

8. MAJOR REASON(S) FOR THIS ~ W-k #// miiw —) 9. 

~ WELL AOULT/CHILO EXAM 

G FAMILY PLANNING 

� COUNSELINGIADVICE 

CJ IMMUNIZATION 

Cl REFERRED BY OTHER PMYWAGENCY 

� ADMINISTRATIVE PURPOSE 

, D ACUTE PROBLEM 

s, � ACUTE PROBLEM, FOLLOW-UP 

VI � CHRONIC PROBLEM, ROUTINE 

.. � CHRONIC PROBLEM. FLARE-UP 

,+ � PRENATAL CARE 

>, � POSTNATAL CARE 

., � POSTOPERATIVE CARE 

7 

(Opemdue bwocedufe) 

,, 

B 

-, 

.. 

. 

, 

:. Li OTHER (Soectfy) 

10. OIASMOSTECMIEMPESETK SEWICESORDEaEWSOVISEO TENSVE9T/-titi~) 

01 � NONE 11 a ONUG FRSBCRI=D 

OZ � LIMITEO HISTORYIESAM 1’2 � X-RAY


03 n GENERAL MISTDRV/EX@M 13 � IN.ECTIGN


w O CLINICAL LAS. TEST 14 0 I-ISA ~=TE2AT10EE


05 Cl BLOOD PRESSURE CNECK 15 n PEEVSIGTHERAPY 

0s 0 EKG 16 � MEDECAL ~Llffi 

07 0 HEARING TEST 17 � PSYCHO~RAFY~W_ 

m o Vlslord TEST LISTENENG 

09 0 EN~Y 1s � DTNSR WOL$fvl 

10 0 OFFICE SURGERY 

11. 

F E NO FOLLOW-UP PLANNED 

z C RETURN AT SPECIFIED TIME 

3 � RETURN IF NEEDED, P.R.N. 

. ~ TELEPHONE FOLLOW. UP PLANNED 

s � REFERREO TO OTHER —MINUTEs 

PHYSICIAN/AGENCY 

. ~ RETURNED TO REFERRING 

PHYSICIAN 

. c; AOMIT TO HOSPITAL 

s G OTHER (Spe+) 

II RA-34-3 DEPARTMENT OF -TN, ~TNJN ANO WELFARE O.M.B. *S-S721OS 

REV. 0-74 PUBLIC HEALTH SERVICE EXPIRATION DATE 12/31/75 

HEALTH RESOURCES AOMINISTRATION 

NATIONAL CENTER FOR HEALTH STATISTICS 

figures. Due to rounding of percents, the sum of 

percentages may not equal 100.0 percent. 

DEFINITIONS: An ambulatory patient is an individual presenting himself for personal health 

services who is neither bedridden nor currently 

admitted to any health care institution on the 

premises. 

An o~~ice is a place that the physician identifies as a location for his ambulatory practice. 

Responsibility over time for patient care and 

professional sexvices rendered there generally 

_ resides with the individual physician rather than 

an institution. 

A visitis a direct personal exchange between 

an ambulatory patient and a physician or a staff 

member working under the physician’s supervision for the purpose of seeking care and 

rendering health services. 

A physiciun is a duly licensed doctor of 

medicine (M. D.) or doctor of osteopathy (D. O.) 

currently in practice who spends time in caring 

for ambulatory patients at an office location. 

Excluded from NAMCS are physicians who 

specifllze in anesthesiology, pathology, radiology; physicians who are federally employed; 

physicians who treat only institutionalized 

patients; physicians employed full time by an 

institution; and physicians who spend no time 

seeing ambulatory patients. 
8 acivancedata — 

Recent Issues of Advance Data From Vital and Health Statistics 

No. 38.	 Office Wits to Psychiatrists, National Ambu- No. 35. An Overview of Nursing Home Characteristics: 

latory Me{lcal care Survey: United States, Provisional Data from the 1977 National 

1975-76 (Issued: August 25,1978) Nursing Home Survey ( In preparation) 

No. 37.	 Office Wits to Dermatologists, National Am- No. 34. Office Vkits to Otolaryngologists, National 

bulatory Medical Care Survey: United States, Ambulatory Medical Care Survey: United 

1975-76 (Issued: August 29,1978) States, 1975-76 (Issued: August 30, 1978) 

No. 36.	 Contraceptive Utilization in the United States: 

1973 and 1976 (Issued: August 18, 1978) 

A complete list of Advance Data From Vital and Health Statistics is available from the Scientific and Technical 

Information Branch. 

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