A Physician and President of a Tampa Health Maintenance Organization

Multiple Choice

A physician and president of a Tampa Health Maintenance Organization (HMO) are attempting to show the benefits of managed health care to an insurance company. The physician believes that certain types of doctors are more cost-effective than others. To investigate this, the president obtained independent random samples of 20 HMO physicians from each of 4 primary specialties - General Practice (GP) , Internal Medicine (IM) , Pediatrics (PED) , and Family Physicians (FP) - and recorded the total charges per member per month for each. A second variable which the president believes influences total charges per member per month is whether the doctor is a foreign or USA medical school graduate. To investigate this, the president also collected data on 20 foreign medical school graduates in each of the 4 primary specialty types described above. So information on charges for 40 doctors (20 foreign and 20 USA medical school graduates) was obtained for each of the 4 specialties. The president has already found out that specialty types and origin of the medical degree do not interact to affect the charges. He has also found out special types do have an impact on average charges. Which of the following tests will be the most appropriate to find out which primary specialty has the highest charges?

A) Tukey-Kramer multiple comparisons procedure for one-way ANOVA
B) Tukey multiple comparisons procedure for two-way ANOVA
C) two-way ANOVA F test for origin of the medical degree effect
D) two-way ANOVA F test for primary specialty effect