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Data and Key VariablesData used to identify the determinants of having a regular doctor or site and how having a regular doctor or site affects the utilization of prevention were extracted from the Medical Expenditure Panel Survey (MEPS), conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics (Agency for Healthcare Research and Quality 1999). The household survey component from 1996, which contained detailed data on demographic characteristics, health conditions, health status, use of medical care services, charges and payments, access to care, satisfaction with care, health insurance, and income and employment, was used. More than twenty thousand individuals representing the U.S. population were surveyed. More details on the information collected by the MEPS 1996 can be found in other studies (Cohen 1997; Vistnes and Monheit 1997).

To test the presence of selection biases, an adjusted Wald test was performed for each service on the endogeneity correction terms, the [lambda]''s. The unbiased effects of having a regular doctor and a site were then calculated based on the parameter estimates. The differences in the effects of having a regular doctor and having a regular site on the five preventive services were obtained. Tests were conducted to determine whether the differences were statistically significant. The biased effects obtained through single-equation estimations were also examined.RESULTSTable 2 presents the cross-tabulation of the type of usual source of care and preventive service use. Among the 15,501 individuals, about 23 percent did not have a usual source of care, whereas approximately 44 percent had a regular doctor and one third had a regular site. Persons without a usual source of care had a lower proportion than individuals who had a usual source of care in receiving prevention within the past two years, a result that was significant at a 99 percent confidence level for all five preventive services. When the comparison was made between having a regular doctor and having a regular site, it was found that a regular doctor outperformed a regular site in providing blood pressure checks, cholesterol level checkups, and flu shots. However, a regular site outperformed a regular doctor in providing pap smears. These findings were significant at a 99 percent confidence level. No statistically significant difference was found between having a regular site and having a regular doctor in receiv ing mammograms. Adjusted Wald tests (F tests) were used to evaluate the joint performance of the additional two exogenous variables identifying the equation. In predicting the probabilities of having a regular doctor and having a regular site, the F test scores were 11.92 and 12.55, respectively. They were significant at a 99 percent confidence level.

This money-back approach forces the retained search firm to conduct a thorough vetting of both the client and the candidate prior to initiating a search. If the firm believes it has no hope of filling the search, there''s no reason to take on the engagement. Similarly, there''s real motivation in ensuring the firm does everything it can to find the ideal candidate for each search it takes on.Boller was ready to give up on retained recruiting when he encountered a search firm that operated on the money-back model. The firm made a careful assessment of the situation and actually declined the first search it was offered, while quickly filling four other positions for the Center for Specialty Care. Even more impressive was the fact that each of the four successful searches was completed in less than two months. Boller not only saw the clinic''s revenues increase through greater. patient volume, but thousands of dollars in search fees were saved.

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