Physician characteristics included age, sex, whether board certified, and whether a graduate of foreign medical school. The physician's "experience with managed care" was captured by the variable "percentage of revenue from managed care." One community factor was whether the physician resides in a town or area with a population less than 200 000 (roughly 8.6% of our sample resided in these towns and areas). We intended for this variable to capture the "rural and small town" effect. Other community factors included 9 regions of the country: New England (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and Connecticut); mid Atlantic (New York, New Jersey, and Pennsylvania); east north Central (Ohio, Indiana, Illinois, Michigan, and Wisconsin); west north Central (Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas); south Atlantic (Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, and Florida); east south Central (Kentucky, Tennessee, Alabama, and Mississippi); west south Central (Arkansas, Louisiana, Oklahoma, and Texas); Mountain (Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, and Nevada); and Pacific (Washington, Oregon, California, Alaska, and Hawaii).