Are resident physicians serving as primary care providers for managed care patients?

BACKGROUND: The rapid growth of managed care is posing new challenges for residency education. This study examines the effect of managed care on family practice residency programs' abilities to provide an ambulatory continuity experience for resident physicians. This paper also assesses the perceived benefits and problems associated with managed care. METHODS: A survey was mailed in the fall of 1995 to the directors of all US family practice residencies. RESULTS: Nearly 75% of residencies had experienced a recent increase in managed care volume. Nearly 75% reported associated benefits. Fifty percent reported associated problems for residency training. Only 20% of residencies had a managed care contract that allowed resident physicians to serve as primary care providers. Residencies use a variety of methods to circumvent these restrictions to enable residents to have a continuity practice. CONCLUSIONS: Managed care organizations create opportunities and challenges for the training of primary care physicians.