Experiences Related to COVID-19 at Physician Offices

2020 NAMCS Physician Induction Interview

The National Ambulatory Medical Care Survey (NAMCS), conducted by the National Center for Health Statistics (NCHS), collects data on visits to physician offices to describe patterns of ambulatory care delivery in the United States. As part of NAMCS, the Physician Induction Interview collects information about practice characteristics at physician offices. Partway through the 2020 NAMCS, NCHS added questions to the Physician Induction Interview to assess physician experiences related to COVID-19 in office-based settings.

Each year, physicians in the NAMCS sample are assigned to one of four interview periods and are contacted by a field representative to conduct the Physician Induction Interview during the assigned interview period. In the 2020 NAMCS, physicians were interviewed about COVID-19-related experiences in interview periods 3 (P3) and 4 (P4). Due to delays in data collection, interviews for P3 and P4 occurred between December 15, 2020 and May 5, 2021. Physicians were asked about experiences in the 3 months prior to their interview, and therefore, estimates for P3 and P4 in the below figures represent physician experiences between September 2020 and May 2021. The data used in these figures are considered preliminary, and the results may change with the final data release. This page will be updated every six months, as additional interview periods are completed in the 2021 NAMCS. More information on survey methodology can be found below the dashboard.

Results on this page show nationally representative estimates of experiences related to COVID-19 among office-based physicians in the United States in the 3 months prior to their NAMCS interview. Estimates on this page include:

  • Ability to test for COVID-19: percentage of physicians responding yes, their office had the ability to test for COVID-19 in the past 3 months.
  • Turn away patients with COVID-19: percentage of physicians responding yes, their office had to turn away or refer elsewhere some, most, or all COVID-19 patients in the past 3 months.
  • Any providers testing positive for COVID-19: percentage of physicians responding yes, at least one type of clinical care provider at their office tested positive for COVID-19 in the past 3 months.

Data are presented according to interview period and can be examined by office type (solo or group practice), specialty type (primary care, surgical, or medical), owner type (physician or physician group, or other type), and urbanicity of office location (large metro area, medium/small metro area, nonmetro area).


Use the drop-down menus to select measures or groups. The left graph shows the selected measure by subgroups of physicians within the selected group, and the right graph shows the selected measure among all physicians. Hover the mouse over a bar to see additional information about a specific estimate.


Technical Notes

  • In Periods 3 and 4 of 2020 NAMCS, 422 out of 774 eligible physicians responded to the Physician Induction Interview, for a response rate of 54.5%.
  • Physicians who responded “not applicable, the office did not have a need to test for COVID-19” were excluded from the “ability to test for COVID-19” denominator (18.7%). Physicians who responded “not applicable, the office did not have any COVID 19 patients” were excluded from the “turn away COVID-19 patients” denominator (16.1%). No physicians were excluded from estimates due to missing data.
  • Estimates are weighted and are nationally representative.
  • Data represent physicians, not physician offices.
  • All estimates shown were assessed against the NCHS Data Presentation Standards for Proportionspdf icon. Estimates that did not meet these reliability standards are still shown but are displayed in an alternate color according to the legend in the dashboard.

Data Source

The preliminary data presented are from the National Center for Health Statistics’ 2020 National Ambulatory Medical Care Survey (NAMCS) Physician Induction Interview. For general details on NAMCS, please visit https://www.cdc.gov/nchs/ahcd/about_ahcd.htm, and for specific details about the 2020 NAMCS Physician Induction Interview, see below.

Definitions

 

Measures

Survey questions used to develop the measures displayed in the above dashboard include:

“During the past 3 months, did your office have the ability to test patients for coronavirus disease (COVID-19) infection?”

  • Estimates show the percentage of physicians responding “yes” to this survey question.
  • Physicians who responded “not applicable – did not need to do any COVID-19 testing” were not included in the denominator.

“During the past 3 months, did your office need to turn away or refer elsewhere any patients with confirmed or presumptive positive coronavirus disease (COVID-19) infection?”

  • Estimates show the percentage of physicians responding yes to this survey question, including a response of “some…,” “most…,” or “all patients were turned away or referred elsewhere.”
  • Physicians who responded “not applicable – the office did not have any COVID-19 patients” were not included in the denominator.

“During the past 3 months, did any of the following clinical care providers in your office test positive for coronavirus disease (COVID-19) infection?”…Physicians, physician assistants, nurse practitioners, certified nurse-midwives, registered nurses/licensed practice nurses, or other clinical providers?

  • Estimates show the percentage of physicians responding yes, that one or more of the above provider types at their office tested positive in the past 3 months.

 

Groups

Measures are stratified by the following characteristics:

Office type:

  • Solo Practice—Physicians responding that they work in a solo practice.
  • Group Practice—Physicians responding that they work with other physicians, such as in a partnership or a group practice.

Owner type:

  • Physician or physician group—Physicians responding that they work at an office owned by a physician or a physician group.
  • Other—Physicians responding that they work at an office that is owned by an entity, such as an insurance company, health plan, hospital, health center, or other health care corporation.

Specialty type (as described in NCHS’ NAMCS documentationpdf icon, pages 111-113):

  • Primary care—Physicians responding that their specialty is primary care.
  • Surgical —Physicians responding that their specialty is surgical.
  • Medical —Physicians responding that their specialty is medical.

Urbanicity of office location (based on NCHS’ Urban-Rural Classification Scheme for Counties):

  • Large metro area—Physicians’ offices in metropolitan statistical areas (MSA) with greater than 1 million people.
  • Medium/small metro area—Physicians’ offices in MSAs with less than 1 million people.
  • Nonmetro area—Physician’s offices in micropolitan statistical areas (urban clusters with a population of at least 10,000 but less than 50,000) or noncore areas (everything else considered non-micropolitan).

 

Survey Design and Sampling

NAMCS is an annual survey of 3,000 physicians working in nonfederally employed office-based settings working in the 50 U.S. states or Washington D.C., sampled from the American Medical Association and the American Osteopathic Association master files. Physicians working in specialties of anesthesiology, radiology, or pathology are not eligible to be sampled. Sampled physicians who had retired or were 85 years or over, were a resident, intern, or fellow, were not principally engaged in patient care activities at the time of the interview, could not be contacted, or were not providing care in an office-based setting were not eligible to complete NAMCS.

NAMCS consists of two parts: 1) a Physician Induction Interview with eligible, responding physicians, and 2) an abstraction of patient visits from those physicians. To provide representative data from across a survey year, the physician sample is divided into 52 subsamples, which are then randomly assigned to the 52 weeks of the survey year. These weekly subsamples are also grouped into four interview periods, with approximately 750 physicians in each period. Physicians are contacted to complete the Physician Induction Interview within a specific date range for their interview period, and then provide a sample of visits for abstraction from the reporting week to which they were assigned. Details regarding interview and reporting periods for the 2020 NAMCS are shown below in Table 1.

COVID-19-related questions were first introduced in the third interview period of the 2020 NAMCS Physician Induction Interview and will continue to be asked of physicians in the 2021 survey. Because of COVID-19, data collection was delayed and some of the interview dates for the 2020 NAMCS Physician Induction Interview occurred in 2021. Additionally, due to safety concerns and logistical challenges related to COVID-19, data abstraction was cancelled for periods 2, 3, and 4 of the 2020 NAMCS.

Table 1. 2020 NAMCS Sample Details
Interview Period Interview Dates COVID-19 Questions Asked Reporting Weeks Reporting Dates Abstraction Occurred
2020 Period 1 (P1) 5/19/2020 – 8/25/2020 No 1-14 1/6/2020 – 4/12/2020 Yes
2020 Period 2 (P2) 7/29/2020 – 11/4/2020 No 15-27 4/13/2020 – 7/12/2020 No
2020 Period 3 (P3) 12/15/2020 – 2/23/2021 Yes 28-40 7/13/2020 – 10/11/2020 No
2020 Period 4 (P4) 2/24/2021 – 5/5/2021 Yes 41-52 10/12/2020 – 1/3/2021 No

Survey Weighting

Physicians were weighted according to their specialty and region. Weights were adjusted using multipurpose iterative proportional fitting, a technique that simultaneously performs calibration, nonresponse adjustment, and weight trimming. Records from periods 3 and 4 were combined and a 2020 Periods 3 and 4 weight was developed, allowing for the development of nationally representative estimates of physician experiences for subsets of the annual physician sample. Estimates on this page are being published prior to final weighting to provide timely access to COVID information.

Suggested Citation

National Center for Health Statistics. 2020 National Ambulatory Medical Care Survey Physician Induction Interview. Experiences Related to COVID-19 at Physician Offices: United States. Generated interactively: .

 

Send comments and questions to ambcare@cdc.gov.

Page last reviewed: October 20, 2021