section iii : primary care physicians

Section III Contents

Distribution of Specialty

Demographics

Education

Practice Characteristics

Specialties and Services

section iii

primary care physicians

Distribution of Specialty

This section provides a summary of physicians who reported having a primary care specialty per guidelines established by HRSA for informing primary care HPSAs[1]. These specialties include family medicine/general practice, internal medicine (general), obstetrics & gynecology, and pediatrics (general). Overall, 6,420 physicians were identified as having a primary care specialty. A large portion of PCPs reported practicing in family medicine/general practice (47.1%), followed by internal medicine (general) (31.0%), pediatrics (general) (11.9%), and obstetrics and gynecology (10.0%).

 

[1] 42 C.F.R. Appendix A to Part 5 (2024).

Demographics

Table 3.1 provides a summary of the demographic characteristics of primary care physicians (PCPs). These trends are similar to those identified in Indiana’s total physician workforce. The overall average age of PCPs was 49.1 years. Male PCPs (51.0 years) were slightly older than female PCPs (46.8 years). Around 4% of PCPs identified as Hispanic, Latina/o, or Spanish origin, and 67% of PCPs identified as White, followed by Asian (17.7%), Black or African American (7.6%), and another race not listed (5.6%).

Table 3.1 - primary care physician Demographic characteristics

Table 3.1 Primary care physician demographic characteristics.
Female Male Gender not Available Total
N % N % N % N %
Total 2,939 100.0 3,353 100.0 128 100.0 6,420 100.0
Mean Age 46.8 51.0 49.9 49.1
Age Groups
Under 35 365 12.4 376 11.2 20 15.6 761 11.9
35-44 1,022 34.8 863 25.7 29 22.7 1,914 29.8
45-54 900 30.6 788 23.5 20 15.6 1,708 26.6
55-64 481 16.4 757 22.6 31 24.2 1,269 19.8
65 and Older 140 4.8 541 16.1 16 12.5 697 10.9
Age not Available 31 1.1 28 0.8 12 9.4 71 1.1
Ethnicity
Hispanic, Latina/o, or Spanish origin 117 4.0 145 4.3 4 3.1 266 4.1
Not Hispanic, Latina/o, or Spanish origin 2,822 96.0 3,208 95.7 124 96.9 6,154 95.9
Race
White 1,927 65.6 2,305 68.7 70 54.7 4,302 67.0
Asian 533 18.1 578 17.2 25 19.5 1,136 17.7
Black or African American 288 9.8 180 5.4 18 14.1 486 7.6
Native Hawaiian/Pacific Islander 7 0.2 11 0.3 1 0.8 19 0.3
American Indian or Alaska Native 3 0.1 2 0.1 0 0.0 5 0.1
Multiracial 57 1.9 53 1.6 5 3.9 115 1.8
Other 124 4.2 224 6.7 9 7.0 357 5.6

Source: Indiana Physician License and Supplemental Survey Data, 2023
Notes: Data on Gender was not provided for every respondent by Indiana Professional Licensing Agency (IPLA). Age was calculated as the difference between the respondent’s date of birth and the date of survey completion.
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Education

Table 3.2 shows where PCPs completed their medical education and residency training. Of the 6,420 physicians who reported a primary care specialty, less than a third (29.3%) obtained their medical degree in Indiana. Another 26.3% reported completing their medical degree in another US state, followed by 25.0% in another country, and 19.5% in a contiguous state. Most physicians reported completing their residency training in Indiana (39.3%), followed by another US state (34.0%) and a contiguous state (26.0%).

Table 3.2 - Location of med. school and residency for Ind. PCPs

Table 3.2 Location of medical school and residency for Indiana primary care physicians.
N %
Total 6,420 100.0
Medical School
Indiana 1,880 29.3
Contiguous State 1,249 19.5
Another US State 1,689 26.3
Another Country 1,602 25.0
Residency
Indiana 2,521 39.3
Contiguous State 1,670 26.0
Another US State 2,184 34.0
Another Country 45 0.7

Source: Indiana Physician License and Supplemental Survey Data, 2023
Notes: Contiguous States include Michigan, Ohio, Kentucky, and Illinois
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Practice Characteristics

Practice Settings

Table 3.3 describes the reported practice settings of Indiana’s primary care physicians. Nearly all (n=6,315; 98.4%) PCPs reported a primary practice setting, 1,272 (19.8%) reported a secondary practice setting, and 307 (4.8%) reported a tertiary practice setting. PCPs most frequently reported their primary practice setting as an office/clinic-single specialty group (19.2%), hospital-inpatient (18.7%), and office/clinic-multi specialty group (17.0%). The hospital-inpatient setting was the most reported secondary practice setting (6.4%) and tertiary practice setting (1.4%).  

Table 3.3 - pcp practice setting characteristics

Table 3.3 Primary care physician practice setting characteristics.
Practice Setting Primary Practice Secondary Practice Tertiary Practice
N % N % N %
Total 6,420 100.0 6,420 100.0 6,420 100.0
Office/Clinic — Solo Practice 509 7.9 70 1.1 16 0.2
Office/Clinic — Partnership 621 9.7 103 1.6 7 0.1
Office/Clinic — Single Specialty Group 1,232 19.2 155 2.4 23 0.4
Office/Clinic — Multi Specialty Group 1,091 17.0 144 2.2 24 0.4
Hospital — Ambulatory Care Center 84 1.3 14 0.2 2 0.0
Hospital — Emergency Department 15 0.2 8 0.1 3 0.0
Hospital — Inpatient 1,203 18.7 414 6.4 90 1.4
Hospital — Outpatient 435 6.8 72 1.1 15 0.2
Federal Government Hospital 50 0.8 3 0.0 1 0.0
Research Laboratory 1 0.0 2 0.0 1 0.0
Medical School 27 0.4 7 0.1 3 0.0
Nursing Home or Extended Care Facility 23 0.4 26 0.4 16 0.2
Home Health Setting 19 0.3 2 0.0 0 0.0
Hospice Care 9 0.1 19 0.3 3 0.0
Federal/State/Community Health Center(s) 252 3.9 38 0.6 6 0.1
Local Health Department 9 0.1 7 0.1 1 0.0
Telemedicine 608 9.5 90 1.4 33 0.5
Volunteer in a Free Clinic 8 0.1 10 0.2 4 0.1
Other 119 1.9 88 1.4 59 0.9
Not Applicable 105 1.6 5,148 80.2 6,113 95.2

Source: Indiana Physician License and Supplemental Survey Data, 2023
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Hours in Patient Care

Table 3.4 summarizes the average hours per week PCPs spent in patient care at their primary, secondary, and tertiary locations. Around half (50.4%) of PCPs reported spending at least 37 hours per week in patient care at their primary practice, with 27.8% reporting an average of 37-40 hours per week and 22.6% reporting 41 or more hours per week. PCPs reported spending fewer hours in secondary and tertiary practices. It was most frequently reported that PCPs spent an average of 5-8 hours per week in patient care at their secondary practice (n=236; 3.7%) and 1-4 hours per week in patient care at their tertiary practice (n=68; 1.1%).

Table 3.4 - Average hours per week in patient care

Table 3.4 Primary care physician average hours per week in patient care.
Average hours per week in patient care Primary Practice Secondary Practice Tertiary Practice
N % N % N %
Total 6,420 100.0 6,420 100.0 6,420 100.0
0 hours per week 29 0.5 69 1.1 34 0.5
1-4 hours per week 120 1.9 212 3.3 68 1.1
5-8 hours per week 131 2.0 236 3.7 39 0.6
9-12 hours per week 188 2.9 180 2.8 38 0.6
13-16 hours per week 159 2.5 83 1.3 8 0.1
17-20 hours per week 302 4.7 115 1.8 9 0.1
21-24 hours per week 287 4.5 70 1.1 6 0.1
25-28 hours per week 322 5.0 34 0.5 7 0.1
29-32 hours per week 537 8.4 21 0.3 3 0.0
33-36 hours per week 897 14.0 21 0.3 6 0.1
37-40 hours per week 1,782 27.8 67 1.0 17 0.3
41 or more hours per week 1,452 22.6 77 1.2 17 0.3
Not applicable 214 3.3 5,235 81.5 6,168 96.1

Source: Indiana Physician License and Supplemental Survey Data, 2023
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Employment Plans

Most primary care physicians (84.7%) reported no planned employment changes for the next two years. When considering those with planned changes, 5.7% planned to decrease hours, 3.8% planned to increase hours, and 1.2% planned to retire in the next two years.

Table 3.5 - Physician employment plans

Table 3.5 Primary care physician employment plans.
Employment plans for the next 2 years N %
Total 6,420 100.0
Continue as you are 5,438 84.7
Increase hours 243 3.8
Decrease hours 365 5.7
Seek non-clinical job 29 0.5
Retire 77 1.2
Unknown 268 4.2

Source: Indiana Physician License and Supplemental Survey Data, 2023
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Patient Panel

Table 3.6 describes the patient panel characteristics of Indiana’s PCPs. Around a quarter (24.5%) reported that some percentage of their patient panel was on a sliding fee scale at their primary practice. Providers most frequently reported that >0%-5% of their primary practice patient panel was on a sliding fee scale. Around 72% of PCPs reported that at least a portion of their primary practice patient panel was comprised of Medicaid recipients, with Medicaid recipients most frequently making up around 11%-20% of patient panels. Additional information about patient panel characteristics at secondary and tertiary practices is shown in Table 3.6 below.  

As shown in Table 3.7, the majority of PCPs (71.6%) reported accepting new Indiana Medicaid patients. Of the 28.4% who reported not accepting new Medicaid patients, the most frequently reported barriers included a full patient panel, policies of practice, and reimbursements rates.

Table 3.6 - Patient panel characteristics

Table 3.6 Primary care physician patient panel characteristics.
Primary Practice Secondary Practice Tertiary Practice
N % N % N %
Percent of Patients on a Sliding Fee Scale
Do not offer a sliding fee scale 1,478 23.0 297 4.6 101 1.6
>0% – 5% 810 12.6 130 2.0 24 0.4
6% – 10% 348 5.4 53 0.8 9 0.1
11% – 20% 181 2.8 30 0.5 6 0.1
21% – 30% 88 1.4 25 0.4 6 0.1
31% – 50% 89 1.4 18 0.3 6 0.1
Greater than 50% 60 0.9 20 0.3 10 0.2
Not Applicable 3,366 52.4 5,847 91.1 6,259 97.5
Percent of Patient Panel who are Medicaid Recipients
Not Accepting Indiana Medicaid 384 6.0 87 1.4 34 0.5
>0% – 5% 655 10.2 131 2.0 20 0.3
6% – 10% 751 11.7 127 2.0 23 0.4
11% – 20% 853 13.3 119 1.9 25 0.4
21% – 30% 822 12.8 134 2.1 27 0.4
31% – 50% 826 12.9 174 2.7 26 0.4
Greater than 50% 716 11.2 151 2.4 32 0.5
Not Applicable 1,413 22.0 5,497 85.6 6,233 97.1

Source: Indiana Physician License and Supplemental Survey Data, 2023
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Table 3.7 - Physician Medicaid participation status

Table 3.7 Primary care physician Medicaid participation status.
N %
Accepting new Indiana Medicaid patients
Accepting new Indiana Medicaid patients 4,594 71.6
Not accepting new Indiana Medicaid patients 1,826 28.4
Barriers to not Accepting New Medicaid Patients
Practicing at Government Facility 23 1.3
Full Patient Panel 249 13.6
Acute Care/Specialist/Hospitalist 26 1.4
Reimbursement Rates 49 2.7
Administrative Burden 13 0.7
Policies of Practice 81 4.4
Managing Medicaid Patients 4 0.2
Not Currently Enrolled as a Medicaid Provider 5 0.3
Not Providing Direct Patient Care 4 0.2
Anticipating Future Acceptance 3 0.2
Low Demand 3 0.2
Not Applicable (locum tenens, Planning to Retire) 1,366 74.8

Source: Indiana Physician License and Supplemental Survey Data, 2023
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Speciality and Services

Telemedicine Services by Specialty

Primary care providers reported providing telemedicine services to Indiana residents (71.1%) more frequently than all physicians combined (61.8%), as seen in Table 2.8 and Table 3.8. Family medicine/general practice made up the largest primary care specialty that reported offering telemedicine services at 56.0%, followed by internal medicine (general) at 23.6%.

Table 3.8 - PCP specialty distribution by telemedicine status

Table 3.8 Specialty distribution among primary care physicians based on telemedicine service status.
Medical Specialty Reported Providing Telemedicine Services to Indiana Residents
Yes No
N % N %
Total 4,564 100.0 1,856 100.0
Family Medicine/General Practice 2,557 56.0 467 25.2
Internal Medicine (General) 1,079 23.6 913 49.2
Obstetrics and Gynecology 370 8.1 272 14.7
Pediatrics (General) 558 12.2 204 11.0

Source: Indiana Physician License and Supplemental Survey Data, 2023
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Addiction Services by Speciality

In subsequent tables, it should be noted that psychiatrists were able to report more than one service they provide and populations they serve. Because of this the total count of psychiatrists providing each service or serving each population will be reported by specialty.

Of 6,420 physicians who reported a primary care specialty, almost a quarter (n=1,449; 22.6%) reported providing at least one addiction service. PCPs most frequently reported providing screening for addiction (n=918), followed by addiction counseling (n=879). Specialties that most often reported providing at least one addiction service included family medicine/general practice (56.8%), internal medicine (general) (30.6%), and obstetrics and gynecology (10.2%).

Table 3.9 - PCP specialty and addiction services

Table 3.9 Primary care physician specialty and addiction services.
Medical Specialty Screening for Addiction Addiction Counseling MAT-Methadone MAT-Buprenorphine MAT-Naltrexone Total Unique PCPs Providing Addiction Services
N % N % N % N % N % N %
Family Medicine/General Practice 539 58.7 517 58.8 23 35.4 277 60.7 207 69.9 823 56.8
Internal Medicine (General) 220 24.0 318 36.2 33 50.8 134 29.4 80 27.0 444 30.6
Obstetrics and Gynecology 130 14.2 35 4.0 9 13.8 44 9.6 9 3.0 148 10.2
Pediatrics (General) 29 3.2 9 1.0 0 0.0 1 0.2 0 0.0 34 2.3
Total 918 100.0 879 100.0 65 100.0 456 100.0 296 100.0 1,449 100.0

Source: Indiana Physician License and Supplemental Survey Data, 2023
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Obstetric Services by Speciality

Primary care physicians play a critical role in providing obstetric services to Indiana residents, as seen in Table 3.10. Of 6,420 PCPs, almost a quarter (n=1,550; 24.1%) reported providing at least one obstetric service compared to 12.7% of all physicians (Table 2.10). The most frequently reported services were post-natal services (n=1,300), pre-natal services (n=896), labor and delivery services (n=690), and high-risk pregnancy screening (n=690). Family medicine/general practice (39.9%) and obstetrics and gynecology (37.7%) were the two specialties that most frequently reported providing at least one obstetric service.

Table 3.10 - Obstetric services by PCP specialty

Table 3.10 Obstetric services by primary care physician specialty.
Medical Specialty High-Risk Pregnancy Screening High-Risk Pregnancy Services Pre-Natal Services Labor and Delivery Post-Natal Services Treatment for OUD-affected Pregnancy Total Unique PCPs Providing Obstetric Services
N % N % N % N % N % N %
Family Medicine/General Practice 209 30.3 93 18.8 352 39.3 180 26.1 537 41.3 76 33.9 618 39.9
Internal Medicine (General) 5 0.7 7 1.4 9 1.0 8 1.2 30 2.3 10 4.5 49 3.2
Obstetrics and Gynecology 476 69.0 391 79.1 529 59.0 492 71.3 437 33.6 134 59.8 585 37.7
Pediatrics (General) 0 0.0 3 0.6 6 0.7 10 1.4 296 22.8 4 1.8 298 19.2
Total 690 100.0 494 100.0 896 100.0 690 100.0 1,300 100.0 224 100.0 1,550 100.0

Source: Indiana Physician License and Supplemental Survey Data, 2023 Click here to download the table above as a CSV.

Pediatric Populations Served by Specialty

As expected, a significant proportion of PCPs (n=3,982; 62.0%) reported serving at least one pediatric population. A total of 3,938 PCPs reported providing services to adolescents, 3,108 reported providing services to children, and 2,612 reported providing services to newborns. Physicians with a specialty in family medicine/general practice made up over half of PCPs (61.6%) serving pediatric populations, followed by pediatrics (general)(18.9%).  

Table 3.11 - Pediatric populations served by PCP

Table 3.11 Pediatric populations served by primary care physicians.
Medical Specialty Newborns Children (ages 2 – 10) Adolescents (ages 11 -19) Total Unique PCPs Serving Pediatric Populations
N % N % N % N %
Family Medicine/General Practice 1,733 66.3 2,192 70.5 2,446 62.1 2,454 61.6
Internal Medicine (General) 105 4.0 141 4.5 289 7.3 296 7.4
Obstetrics and Gynecology 41 1.6 38 1.2 473 12.0 480 12.1
Pediatrics (General) 733 28.1 737 23.7 730 18.5 752 18.9
Total 2,612 100.0 3,108 100.0 3,938 100.0 3,982 100.0

Source: Indiana Physician License and Supplemental Survey Data, 2023 Click here to download the table above as a CSV.

Adult and Special Populations Served by Specialty

Most primary care physicians (n=5,737; 89.4%) reported serving at least one population of interest described in Table 3.12 below. The populations that PCPs most frequently reported serving included adults (n=5,402), geriatric (n=4,500), individuals with disabilities (n=3,248), and veterans or individuals who have served in the military (n=2,792).Physicians with a specialty in family medicine/general practice made up over half (51.0%) of PCPs who reported serving these groups of interest, followed by general internal medicine (33.6%).   

Table 3.12 - Adult and special populations served by PCP

Table 3.12 Adult and special populations served by primary care physicians.
Medical Specialty Adults Individuals who are Incarcerated Geriatric Pregnant Women Individuals with Disabilities Individuals in Recovery Veterans/ Individuals who have Served in the Military Total Unique PCPs
N % N % N % N % N % N % N % N %
Family Medicine/General Practice 2,901 53.7 416 40.5 2,584 57.4 1,019 52.8 1,954 60.2 1,355 64.6 1,835 65.7 2,926 51.0
Internal Medicine (General) 1,876 34.7 381 37.1 1,536 34.1 313 16.2 780 24.0 504 24.0 734 26.3 1,930 33.6
Obstetrics and Gynecology 557 10.3 227 22.1 370 8.2 592 30.7 309 9.5 229 10.9 219 7.8 636 11.1
Pediatrics (General) 68 1.3 2 0.2 10 0.2 7 0.4 205 6.3 11 0.5 4 0.1 245 4.3
Total 5,402 100.0 1,026 100.0 4,500 100.0 1,931 100.0 3,248 100.0 2,099 100.0 2,792 100.0 5,737 100.0

Source: Indiana Physician License and Supplemental Survey Data, 2023 Click here to download the table above as a CSV.

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Psychiatrists

SECTION IV