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Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

It has often been said that a great part of the strength of Aslib lies in the fact that it brings together those whose experience has been gained in many widely differing fields but who have a common interest in the means by which information may be collected and disseminated to the greatest advantage. Lists of its members have, therefore, a more than ordinary value since they present, in miniature, a cross‐section of institutions and individuals who share this special interest.

FROM 5th to 8th October, 1951, Aslib was fortunate in holding its Annual Conference again at Ashorne Hill, near Leamington Spa, and our thanks are due for the third time to Colonel and Mrs. J. H. Alexander and their staff for the excellence of the catering and domestic arrangements. The weather also co‐operated and sunshine displayed all the autumn beauties of the garden and countryside.

Public hospitals have long been major players in the US health care delivery system. However, many public hospitals have privatized during the past few decades. The purpose of this chapter was to investigate the impact of public hospitals' privatization on community orientation (CO). This longitudinal study used a national sample of nonfederal acute-care public hospitals (1997–2010). Negative binomial regression models with hospital-level and year fixed effects were used to estimate the relationships. Our findings suggested that privatization was associated with a 14% increase in the number of CO activities, on average, compared with the number of CO activities prior to privatization. Public hospitals privatizing to for-profit status exhibited a 29% increase in the number of CO activities, relative to an insignificant 9% increase for public hospitals privatizing to not-for-profit status.

Thisissue of Aslib Proceedings is mainly devoted to papers presented at the 24th Annual Conference, held at Ashorne Hill, near Learnington Spa, Warwickshire, from 9 to 11 September, 1949. In addition, we have pleasure in printing the annual report and accounts of the British Union Catalogue of Periodicals.

This issue of Aslib Proceedings is mainly devoted to papers presented at the 24th Annual Conference, held at Ashorne Hill, near Leamington Spa, Warwickshire, from 9 to 11 September, 1949. In addition, we have pleasure in printing the annual report and accounts of the British Union Catalogue of Periodicals.

Deliberate practice (DP) is an innovative training method for improving psychotherapy skills acquisition and expertise in the twenty-first century. I introduce the reader to the principles and processes of DP and the rationale for its use. The concept of DP is not new, indeed it is used to support the improvement of performance in diverse areas, from sport to music. However, its application to psychotherapy is still in its infancy. Firstly, I provide the rationale for including DP as a method of therapist training based on research that illustrates that many of the current criteria that we use to identify expertise have little to no added impact on client outcomes. Additionally, some of the limitations of current traditional training regimes are outlined, along with the emerging evidence base for DP as a training method that can help improve the acquisition of therapeutic skills and expertise.