Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

Unfolding similarity in interphysician networks: the impact of institutional and professional homophily

Authors: Daniele Mascia, Fausto Di Vincenzo, Valentina Iacopino, Maria Pia Fantini, Americo Cicchetti

Published in: BMC Health Services Research | Issue 1/2015

Login to get access

Abstract

Background

Modern healthcare is characterized by high complexity due to the proliferation of specialties, professional roles, and priorities within organizations. To perform clinical interventions, knowledge distributed across units, directorates and individuals needs to be integrated. Formal and/or informal mechanisms may be used to coordinate knowledge and tasks within organizations. Although the literature has recently considered the role of physicians’ professional networks in the diffusion of knowledge, several concerns remain about the mechanisms through which these networks emerge within healthcare organizations. The aim of the present paper is to explore the impact of institutional and professional homophilies on the formation of interphysician professional networks.

Methods

We collected data on a community of around 300 physicians working at a local health authority within the Italian National Health Service. We employed multiple regression quadratic assignment procedures to explore the extent to which institutional and professional homophilies influence the formation of interphysician networks.

Results

We found that both institutional and professional homophilies matter in explaining interphysician networks. Physicians who had similar fields of interest or belonged to the same organizational structure were more likely to establish professional relationships. In addition, professional homophily was more relevant than institutional affiliation in explaining collaborative ties.

Conclusions

Our findings have organizational implications and provide useful information for managers who are responsible for undertaking organizational restructuring. Healthcare executives and administrators may want to consider the structure of advice networks while adopting new organizational structures.
Literature
1.
Shortell SM, Rundall TG. Physician-organization relationships: social networks and strategic intent. In: Mick SS, Wyttenbach ME, editors. Advance in health care organizational theory. San Francisco: Jossey-Bass; 2003. p. 143–97.
2.
West E, Barron DN, Dowsett J, Newton JN. Hierarchies and cliques in the social networks of health care professionals: implications for the design of dissemination strategies. Soc Sci Med. 1999;48:633–46.CrossRefPubMed
3.
Wensing A, van Lieshout J, Koetsenruiter J, Reeves D. Informal exchange networks for chronic illness care in primary care practices: an observational study. Implement Sci. 2010;5:1–10.CrossRef
4.
Winkelman WJ, Choo CW. Provider-sponsored virtual communities for chronic patients: improving health outcomes through organizational patient-centred knowledge management. Health Expect. 2003;6:352–8.CrossRefPubMed
5.
Ferlie E, Fitzgerald L, Wood M, Hawkins C. The nonspread of innovations: the mediating role of professionals. Acad Manage J. 2005;48:117–34.CrossRef
6.
7.
Boyer L, Belzeaux R, Maurel O, Baumstrarck-Barrau K, Samuelian JC. A social network analysis of healthcare professional relationships in a French hospital. Int J Health Care Qual Assur. 2010;23:460–9.CrossRefPubMed
8.
Fattore G, Frosini F, Salvatore D, Tozzi V. Social network analysis in primary care: the impact of interactions on prescriving behavior. Health Policy. 2009;92:141–8.CrossRefPubMed
9.
Fattore G, Salvatore D. Network organizations of general practitioners: antecedents of formation and consequences of participation. BMC Health Serv Res. 2010;10:118–30.CrossRefPubMedPubMedCentral
10.
Dunn AG, Westbrook JI. Interpreting social network metrics in healthcare organizations: a review and guide to validating small networks. Soc Sci Med. 2011;72:1064–8.CrossRefPubMed
11.
Mascia D, Cicchetti A. Physician social capital and the reported adoption of evidence-based medicine: exploring the role of structural holes. Soc Sci Med. 2011;72:798–805.CrossRefPubMed
12.
Cunningham FC, Ranmuthugala G, Plumb J, Georgiou A, Westbrook JI, Braithwaite J. Health professional networks as a vector for improving healthcare quality and safety: a systematic review. BMJ Qual Saf. 2012;21:239–49.CrossRefPubMed
13.
Coleman JS, Katz E, Menzel H. Medical innovation: a diffusion study. The Bobbs-Merrill Company: Indianapolis; 1966.
14.
Creswick N, Westbrook JI. Social network analysis of medication advice-seeking interactions among staff in an Australian hospital. Int J Med Inform. 2010;79:116–25.CrossRef
15.
Scott J, Tallia A, Crosson JC, Orzano AJ, Stroebel C, DiCicco-Bloom B, et al. Social network analysis as an analitic tool for interaction patterns in primary care practices. Ann Fam Med. 2005;3:1–35.CrossRef
16.
Lurie SJ, Fogg TT, Dozier AM. Social network analysis as a method of assessing institutional culture: three case studies. Acad Med. 2009;84:8–23.CrossRef
17.
Chambers D, Wilson P, Thompson C, Harden M. Social network analysis in healthcare settings: a systematic scoping review. PLoS One. 2012;7:41–9.
18.
Christakis N, Fowler JH. Contagion in prescribing behavior among networks of doctors. Mark Sci. 2011;30:213–6.CrossRef
19.
McPherson M, Smith-Lovin L, Cook JM. Birds of feather: homophily in social networks. Annu Rev Soci. 2001;27:415–44.CrossRef
20.
Rivera MT, Soderstrom SB, Uzzi B. Dynamics of dyads in social networks: assortative, relational, and proximity mechanism. Annu Rev Sociol. 2010;36:91–115.CrossRef
21.
McPherson M, Smith-Lovin L. Homophily in voluntary organizations: status distance and the composition of Face-to-Face groups. Am Sociol Rev. 1987;52:370–9.CrossRef
22.
Mehra A, Kilduff M, Brass DJ. At the margins: a distinctiveness approach to the social identity and social networks of underrepresented groups. Acad Manage J. 1998;41:441–52.CrossRef
23.
Wimmer A, Lewis K. Beyond and below racial homophily: ERG models of a friendship network documented on facebook. Am J Sociol. 2010;116:583–642.CrossRefPubMed
24.
Kossinets G, Watts DJ. Origins of Homophily in an evolving social network. Am J Sociol. 2009;115:405–50.CrossRef
25.
Goodreau SM, Kitts JA, Morris M. Birds of a feather, or friend of a friend? Using Exponential Random Graph Models to investigate adolescent social networks. Demography. 2009;46:103–25.CrossRefPubMedPubMedCentral
26.
West E, Barron DN. Social and geographical buondaries around senior nurse and physicians leaders: an application of social network analysis. Can J Nurs. 2005;37:132–48.
27.
Bacharach SB, Bamberger PA, Vashdi D. Diversity and homophily at work: supportive relations among white and African-American peers. Acad Manage J. 2005;48:619–44.CrossRef
28.
Lazega E, Mounier L, Snijders T, Tubaro P. Norms, status and the dynamics of advice networks: a case study. Soc Networks. 2009;32:18–29.
29.
Mascia D, Cicchetti A, Fantini MP, Damiani G, Ricciardi W. Physicians’ propensity to collaborate and their attitude towards EBM: a cross-sectional study. BMC Health Serv Res. 2011;11:172–83.CrossRefPubMedPubMedCentral
30.
Keating NL, Ayanian JZ, Cleary PD, Marsden PV. Factors affecting influential discussions among physicians: a Social Network Analysis of a Primary Care Practice. Soc Gen Intern Med. 2007;22:794–8.CrossRef
31.
32.
Mascia D, Morandi F, Cicchetti A. Looking good or doing better? Patterns of decoupling in the implementation of clinical directorates. Health Care Manage Rev. 2014;39:111–23.CrossRefPubMed
33.
Mintzberg H. The structuring of organizations. Englewood Cliffs: Prentice-Hall; 1970.
34.
Dunnion M, Dunne E. Clinical directorates: stakeholders’ knowledge and expectations. Br J Health Care Manag. 2004;10:10–7.
35.
Braithwaite J, Westbrook MT, Hindle D, Iedema RA, Black DA. Does restructuring hospitals result in greater efficiency? – An empirical test using diachronic data. Health Serv Manage Res. 2006;19:1–12.CrossRefPubMed
36.
Ibarra H. Paving an alternative route: gender differences in managerial networks. Soc Psychol Q. 1997;60:91–102.CrossRef
37.
Burt RS. The network structure of social capital. New York: Jai Press Ltd; 2000.
38.
Mergel I, Heurta T, van Stelle J. How do networkers network? PNG working paper.
39.
Merton RK. Contributions to the theory of reference group behavior. Social Theory and Social Structure: New York, Free Press; 1968.
40.
Mascia D, Cicchetti A, Damiani G. “Us and them”: a social network analysis of physicians’ professional networks and their attitudes towards EBM. BMC Health Serv Res. 2013;13:429–37.CrossRefPubMedPubMedCentral
41.
Burt RS. Social contagion and innovation: cohesion versus structural equivalence. Am J Sociol. 1987;92:1287–335.CrossRef
42.
Granovetter MS. The strength of weak ties. Ame J Sociol. 1973;78:1360–80.CrossRef
43.
Borgatti SP, Everett MG, Freeman LG. UCINET 6 for windows: software for social network analysis. Harvard: Analytic Technologies; 2002.
44.
Feld S. Structural determinants of similarity among associates. Am Sociol Rev. 1982;47:797–801.CrossRef
45.
Wasserman S, Faust K. Social network analysis: methods and applications. New York: Cambridge University Press; 1994.CrossRef
46.
Krackhardt D. Predicting with networks: a multiple regression approach to analyzing dyadic data. Soc Networks. 1988;10:359–81.CrossRef
47.
Dekker D, Krackhardt D, Snijders TAB. Sensitivity of MRQAP tests to collinearity and autocorrelation conditions. Psikometrica. 2007;72:563–81.CrossRef
48.
Abott A. The system of professions. Chicago: University of Chicago Press; 1988.
49.
Moody J. Race, school integration, and friendship segregation in America. Am J Sociol. 2001;107:679–716.CrossRef
50.
Thompson M. Structural and epistemic parameters in communities of practice. Organization Science. 2005;16:151–64.CrossRef
Metadata
Title
Unfolding similarity in interphysician networks: the impact of institutional and professional homophily
Authors
Daniele Mascia
Fausto Di Vincenzo
Valentina Iacopino
Maria Pia Fantini
Americo Cicchetti
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0748-9

Other articles of this Issue 1/2015

BMC Health Services Research 1/2015 Go to the issue

Research article

Improving access to medicines through centralised dispensing in the public sector: a case study of the Chronic Dispensing Unit in the Western Cape Province, South Africa

Research article

Performing well in financial management and quality of care: evidence from hospital process measures for treatment of cardiovascular disease

Research article

Changes in public attitudes towards confidential adolescent sexual and reproductive health services in Lithuania after the introduction of new legislation: findings from the cross-sectional surveys conducted in 2005 and 2012

Research article

Determinants of emergency response responsibility perceptions in the local public health workforce after China’s health sector restructuring

Research article

Adherence to anti diabetic medication among patients with diabetes in eastern Uganda; a cross sectional study

Research article

The rise of digital direct-to-consumer advertising?: Comparison of direct-to-consumer advertising expenditure trends from publicly available data sources and global policy implications