Regional culture and adaptive behavior of physicians

Abstract

We examine the possibility that regional differentiation of occupations may shed light on how professional behavior adapts to environmental change. Based on the relative prevalence of occupational categories, we defined five geographic regions within the 48 contiguous United States. 77 psychometric, demographic and cultural metrics that covaried significantly with geographic regions by ANOVA were subjected to principal component analysis (PCA), from which three primary clusters emerged. A panel of judges scored the occupations in these clusters for three primary characteristics: generation of variance (Va), reconciliation of variance with institutional procedures (Re) or implementation of standard institutional practice (Pr). By plotting composites of the clustered elements in a 3-dimensional (Va, Re, Pr) matrix, substantially overlapping regional composites emerged for psychological, cultural and occupational metrics. Based on this putative psychological and cultural differentiation of geographic regions, we asked whether adaptive change in physician-and, by extension, of other professional-behavior might be more strongly correlated with intrinsic (e. g. psychological) or extrinsic (e. g. cultural) factors. Based on significant regional differences in patient behavior and minimal regional differences in physician psychology, we suggest that extrinsic factors may play a more direct role in changing professional behavior than intrinsic factors. © 2011 The Author(s).