Little is known about the prevalence of focused expertise (special areas of expertise within a clinical field) among physicians,
yet such expertise may influence how care is delivered. We surveyed general internists, pediatricians, cardiologists, infectious
disease specialists, and orthopedic surgeons to describe the prevalence of focused expertise and identify associated physician
and practice characteristics. About one quarter of generalists and three quarters of specialists reported a focused expertise
within their primary specialty. Hospital-based physicians more often reported such expertise, and physicians reimbursed by
capitation less often reported expertise. Learning how focused expertise affects processes and outcomes of care will contribute
to decisions about physician training and staffing of medical groups.
Key words physician training - primary care - specialty care - manpower
Dr. Keating was the recipient of a National Research Service Award from the Agency for Healthcare Research and Quality, Rockville,
MD, Dr. Ayanian was a Generalist Physician Faculty Scholar of the Robert Wood Johnson Foundation, Princeton, NJ. This study
was supported by the Primary Care Research and Education Fund of Brigham and Women’s Hospital.