Surgical specialization in a limited health care profession: Countervailing forces shaping health care delivery

Abstract

This study investigated correlates of surgical specialization among a group of no~hysician specialistspodiatrists. Placed in the context of a countervailing powers perspective, we investigate one research question not previously examined among a group of limited-health professionals: Is the current world environment ofpodiatrists (e.g., practice locations, world in a hospital, physician referrals), as compared to their prior education and sociodemographic characteristics, more likely to be associated with surgical specialization? Results show that respondents who practiced in more than one office location, who made referrals to endocrinologists, and who had full medical-staff privileges in a hospital had the greatest likelihood of claiming specialization in surgery. Implications of the findings are discussed in terms of how developments in podiatry are related to a reconfiguration of health care delivery by involving podiatrists increasingly with the traditional world and authority of physicians.