{"id":"https://openalex.org/W1964602125","doi":"https://doi.org/10.1056/nejmp0808076","title":"The Independent Physician \u2014 Going, Going . . .","display_name":"The Independent Physician \u2014 Going, Going . . .","publication_year":2009,"publication_date":"2009-02-11","ids":{"openalex":"https://openalex.org/W1964602125","doi":"https://doi.org/10.1056/nejmp0808076","mag":"1964602125","pmid":"https://pubmed.ncbi.nlm.nih.gov/19213678"},"language":"en","primary_location":{"id":"doi:10.1056/nejmp0808076","doi":"https://doi.org/10.1056/nejmp0808076","is_oa":false,"landing_page_url":"https://doi.org/10.1056/nejmp0808076","pdf_url":null,"source":{"id":"https://openalex.org/S62468778","display_name":"New England Journal of Medicine","issn_l":"0028-4793","issn":["0028-4793","0096-6762","1533-4406","2331-4710"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320239","host_organization_name":"Massachusetts Medical Society","host_organization_lineage":["https://openalex.org/P4310320239"],"host_organization_lineage_names":["Massachusetts Medical Society"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"New England Journal of Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5111688590","display_name":"Stephen L. Isaacs","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210136627","display_name":"Jellinek","ror":"https://ror.org/02vsng207","country_code":"NL","type":"nonprofit","lineage":["https://openalex.org/I4210136627"]},{"id":"https://openalex.org/I4405272384","display_name":"Physicians Foundation","ror":"https://ror.org/043kaga42","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I4405272384"]}],"countries":["NL","US"],"is_corresponding":false,"raw_author_name":"Stephen L. Isaacs","raw_affiliation_strings":["Isaacs/Jellinek, San Francisco, USA","Mr. Isaacs and Dr. Jellinek are partners in Isaacs/Jellinek, a San Francisco\u2013based firm that advises health foundations. Dr. Ray is vice president of the Physicians' Foundation, Boston"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Isaacs/Jellinek, San Francisco, USA","institution_ids":["https://openalex.org/I4210136627"]},{"raw_affiliation_string":"Mr. Isaacs and Dr. Jellinek are partners in Isaacs/Jellinek, a San Francisco\u2013based firm that advises health foundations. Dr. Ray is vice president of the Physicians' Foundation, Boston","institution_ids":["https://openalex.org/I4210136627","https://openalex.org/I4405272384"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5091722950","display_name":"Paul S. Jellinek","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210136627","display_name":"Jellinek","ror":"https://ror.org/02vsng207","country_code":"NL","type":"nonprofit","lineage":["https://openalex.org/I4210136627"]},{"id":"https://openalex.org/I4405272384","display_name":"Physicians Foundation","ror":"https://ror.org/043kaga42","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I4405272384"]}],"countries":["NL","US"],"is_corresponding":false,"raw_author_name":"Paul S. Jellinek","raw_affiliation_strings":["Mr. Isaacs and Dr. Jellinek are partners in Isaacs/Jellinek, a San Francisco\u2013based firm that advises health foundations. Dr. Ray is vice president of the Physicians' Foundation, Boston"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mr. Isaacs and Dr. Jellinek are partners in Isaacs/Jellinek, a San Francisco\u2013based firm that advises health foundations. Dr. Ray is vice president of the Physicians' Foundation, Boston","institution_ids":["https://openalex.org/I4210136627","https://openalex.org/I4405272384"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5019204468","display_name":"Walker L. Ray","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210136627","display_name":"Jellinek","ror":"https://ror.org/02vsng207","country_code":"NL","type":"nonprofit","lineage":["https://openalex.org/I4210136627"]},{"id":"https://openalex.org/I4405272384","display_name":"Physicians Foundation","ror":"https://ror.org/043kaga42","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I4405272384"]}],"countries":["NL","US"],"is_corresponding":false,"raw_author_name":"Walker L. Ray","raw_affiliation_strings":["Mr. Isaacs and Dr. Jellinek are partners in Isaacs/Jellinek, a San Francisco\u2013based firm that advises health foundations. Dr. Ray is vice president of the Physicians' Foundation, Boston"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mr. Isaacs and Dr. Jellinek are partners in Isaacs/Jellinek, a San Francisco\u2013based firm that advises health foundations. Dr. Ray is vice president of the Physicians' Foundation, Boston","institution_ids":["https://openalex.org/I4210136627","https://openalex.org/I4405272384"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":11.667,"has_fulltext":false,"cited_by_count":49,"citation_normalized_percentile":{"value":0.98088008,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":87,"max":99},"biblio":{"volume":"360","issue":"7","first_page":"655","last_page":"657"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9384999871253967,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9384999871253967,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11990","display_name":"Global Health Workforce Issues","score":0.027699999511241913,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11590","display_name":"Primary Care and Health Outcomes","score":0.026799999177455902,"subfield":{"id":"https://openalex.org/subfields/2714","display_name":"Family Practice"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/private-physicians","display_name":"private physicians","score":0.6899999976158142},{"id":"https://openalex.org/keywords/physician-practice-ownership","display_name":"physician practice ownership","score":0.6549999713897705},{"id":"https://openalex.org/keywords/physician-employment","display_name":"physician employment","score":0.8820000290870667},{"id":"https://openalex.org/keywords/physician-migration","display_name":"physician migration","score":0.578000009059906},{"id":"https://openalex.org/keywords/health-insurance-coverage","display_name":"health insurance coverage","score":0.7459999918937683},{"id":"https://openalex.org/keywords/uninsured-patients","display_name":"uninsured patients","score":0.7429999709129333},{"id":"https://openalex.org/keywords/future-of-medicine","display_name":"future of medicine","score":0.6060000061988831}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8474239110946655},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.6012561321258545},{"id":"https://openalex.org/C2983635472","wikidata":"https://www.wikidata.org/wiki/Q334911","display_name":"Health insurance","level":3,"score":0.49496668577194214},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.48317113518714905},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.09737592935562134},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D005791","descriptor_name":"Patient Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008511","descriptor_name":"Medicine","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":false},{"descriptor_ui":"D008511","descriptor_name":"Medicine","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":false},{"descriptor_ui":"D011216","descriptor_name":"Practice Management, Medical","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":true},{"descriptor_ui":"D011331","descriptor_name":"Private Practice","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":true},{"descriptor_ui":"D011331","descriptor_name":"Private Practice","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D013038","descriptor_name":"Specialization","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019538","descriptor_name":"Health Care Surveys","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1056/nejmp0808076","doi":"https://doi.org/10.1056/nejmp0808076","is_oa":false,"landing_page_url":"https://doi.org/10.1056/nejmp0808076","pdf_url":null,"source":{"id":"https://openalex.org/S62468778","display_name":"New England Journal of Medicine","issn_l":"0028-4793","issn":["0028-4793","0096-6762","1533-4406","2331-4710"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320239","host_organization_name":"Massachusetts Medical Society","host_organization_lineage":["https://openalex.org/P4310320239"],"host_organization_lineage_names":["Massachusetts Medical Society"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"New England Journal of Medicine","raw_type":"journal-article"},{"id":"pmid:19213678","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/19213678","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The New England journal of medicine","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":3,"referenced_works":["https://openalex.org/W2134177662","https://openalex.org/W2176954361","https://openalex.org/W2489949844"],"related_works":["https://openalex.org/W1841065168","https://openalex.org/W7113488397","https://openalex.org/W3025655260","https://openalex.org/W4233990298","https://openalex.org/W2977203176","https://openalex.org/W168775268","https://openalex.org/W2474332016","https://openalex.org/W2793267646","https://openalex.org/W4234457508","https://openalex.org/W2474836657"],"abstract_inverted_index":{"Despite":[0],"the":[1,16,19,25,56,61,91,96],"current":[2],"focus":[3],"on":[4],"expanding":[5],"health":[6],"insurance":[7],"coverage,":[8],"relatively":[9],"little":[10],"attention":[11],"has":[12,78],"been":[13,67,79],"paid":[14],"to":[15,32,42],"future":[17],"of":[18,58,63,70,85],"physicians":[20,72],"who":[21,73],"provide":[22],"care":[23,57],"for":[24,55,88],"insured":[26],"and":[27,52,60],"uninsured":[28],"alike":[29],"\u2014":[30],"specifically,":[31],"their":[33,75],"ongoing":[34],"migration":[35],"from":[36],"independent":[37],"solo":[38],"or":[39],"small-group":[40],"practices":[41],"larger-group":[43],"practices,":[44],"where":[45],"they":[46],"are":[47],"often":[48],"employees.":[49],"This":[50],"trend":[51],"its":[53],"consequences":[54],"patients":[59],"practice":[62,77],"medicine":[64],"have":[65],"scarcely":[66],"explored.The":[68],"percentage":[69],"U.S.":[71],"own":[74,76],"declining":[80],"at":[81,89],"an":[82],"annual":[83],"rate":[84],"approximately":[86],"2%":[87],"least":[90],"past":[92],"25":[93],"years.":[94],"Although":[95],"decline":[97],"is":[98],".":[99,100,101]},"counts_by_year":[{"year":2024,"cited_by_count":1},{"year":2023,"cited_by_count":2},{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":1},{"year":2019,"cited_by_count":4},{"year":2018,"cited_by_count":2},{"year":2017,"cited_by_count":2},{"year":2016,"cited_by_count":1},{"year":2015,"cited_by_count":3},{"year":2014,"cited_by_count":5},{"year":2013,"cited_by_count":8},{"year":2012,"cited_by_count":8}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2016-06-24T00:00:00"}