Centers for Disease Control and PreventionSafer Healthier People


About N C H S graphic and link
Información en Español
Fastats A-Z provides health statistics and links to additional sources of information
N C H S help graphic and link
Coming Events graphic and link
Surveys and Data Collection Systems graphic and link
National Health and Nutrition Examination Survey graphic and link
National Health Care Survey graphic and link
National Health Interview Survey graphic and link
National Immunization Survey graphic and link
Longitudinal Studies of Aging (LSOAs)
National Survey of Family Growth graphic and link
State and Local Area Integrated Telephone Survey graphic and link
National Vital Statistics System graphic and link
Initiatives graphic and link
Aging Activities graphic and link
Disease Classification graphic and link
Healthy People graphic and link
Injury graphic and link
Research and Development graphic and link
Research Data Center
NCHS Press Room
News Releases graphic and link
Publications and Information Products graphic and link
Statistical Export and Tabulation System
Listserv graphic and link
Graphic and link to FEDSTATS and other sites
Download graphic
Adobe Acrobat Reader graphic and link
PowerPoint Viewer 2003 graphic and link
National Center for Health Statistics 3311 Toledo Road Hyattsville, Maryland 20782
Toll Free Data Inquiries 1-866-441-NCHS


CDC Home Search Health Topics A-Z
N C H S home page graphic and link

N A M C S logoAmbulatory Health Care Data
NAMCS/NHAMCS Home | NAMCS Participants 
CDC/NCHS Privacy Policy Notice
| Accessibility
Site Index | Search NCHS | NCHS Home | Contact Us
For more information, contact the Ambulatory Care Statistics Branch at (301) 458-4600

Welcome NAMCS Participants!

"Data from the National Ambulatory Medical Care Survey are essential to understanding the patterns of health care in America. We need this information to design the best health care programs and to develop the most effective health policies. We appreciate the valuable time that health professionals share with us in providing their information." -- Mike Leavitt, Secretary of Health and Human Services

"The best scientific information is the cornerstone of our efforts to improve health and prevent disease. We depend on the National Ambulatory Medical Care Survey for current and comprehensive health data. I urge you to participate in this important study. We value your cooperation." -- Julie L. Gerberding, M.D., M.P.H., Director, Centers for Disease Control and Prevention

bullet graphicContinuing Medical Education for Health Care Providers

The course entitled "National Ambulatory Medical Care Survey Methods: What Clinicians Need to Know" is now eligible for 1.25 hours of Category 1 continuing medical education (CME), 1.4 hours of continuing nursing education (CNE) and 0.1 continuing education (CEU) credits. Please click here for more information.  

bullet graphicWhat is the NAMCS?
bullet graphicNAMCS Participation
bullet graphic2008 Highlights
bullet graphicSurvey Instruments

bullet graphicCervical Cancer Screening Supplement
bullet graphicCommunity Health Centers
bullet graphicConfidentiality and Privacy
bullet graphicHIPAA Privacy Rule and NAMCS
bullet graphicData Utilization
bullet graphicProfessional Endorsements
bullet graphicContact Information

bullet graphicWatch an Audio-Visual Presentation on the NAMCS
(requires Flash 4 player or higher) Download it now!

What is the NAMCS?

The National Ambulatory Medical Care Survey (NAMCS) is the Nation’s foremost study of ambulatory care in physicians’ offices and has been conducted since 1973.

Each year 3,000 physicians are randomly selected to provide data on approximately 30 patient visits over a 1-week period.

These data are widely used by health care researchers, medical schools, policy analysts, congressional staff, the news media, and many others to improve our knowledge of medical practice patterns.

Reliable NAMCS data depend on complete reports from all sampled physicians. Data from all sample cases are needed to ensure that policy decisions are based on the most accurate data possible.

Your participation is important.

N A M C S graphic - Your participation is important

NAMCS Participation

bullet graphicWho is eligible to participate?
Nonfederally employed physicians (excluding those in the specialties of anesthesiology, radiology, and pathology) who are classified by the American Medical Association (AMA) or the American Osteopathic Association (AOA) as primarily engaged in office-based patient care are randomly chosen to participate in the NAMCS.

bullet graphicWhy participate?
NAMCS participation is important because without your participation, neither you nor other physicians like you can benefit from being represented in the national description of office-based patient care. You were randomly chosen to represent not only yourself but also other physicians in your same geographic region and medical specialty.

bullet graphicWhat are the benefits of participating?
By participating in the NAMCS, you will be able to contribute to the national description of office-based patient care. Participation will result in more reliable collection of data and will permit researchers and other physicians to assess medical and ambulatory risks by using the NAMCS data. Failure to participate lessens the accuracy of data used by physicians and other researchers.

If you would like more information on participation, please contact David Woodwell at dwoodwell@cdc.gov or (800)392-2862 or visit our Ambulatory Health Care Data home page.

2008 Highlights

bullet graphicCervical Cancer Screening Supplement
The supplement was included for the first time in the 2006 NAMCS.  It was used again in 2007, and has been continued for 2008.

Background
CDC's National Center for Health Statistics and National Center for Chronic Disease Prevention and Health Promotion have joined forces to collect information on the screening of cervical cancer by private, office-based physicians in the United States.

Genital human papillomavirus (HPV) infection is common among sexually active populations. There is considerable new information about HPV infection, transmission, and methods of prevention. In addition, a new DNA test to detect HPV as well as newly approved indications for HPV testing have important implications for clinicians in both their cervical cancer screening practices and their management of positive HPV diagnoses among female patients and their sex partners. There is recognition that this new information may require different approaches to cervical cancer screening in primary care practice, as well as new information that needs to be conveyed when counseling and educating patients and their sex partners.

How to Participate
If you have been asked to be part of the NAMCS, you may also have been asked to complete the Cervical Cancer Screening Supplement (CCSS). The supplement applies to physicians in general and family practice, internal medicine, obstetrics and gynecology, and those working in community health centers.  We hope you will choose to help us in this endeavor. It does not  request any confidential information.

If you believe you are eligible and would like to participate, please contact your Census Representative who will be glad to assist you and answer any questions you may have. Thank you for being part of this important research study!

bullet graphicCommunity Health Centers
The 2008 NAMCS includes a sample of Community Health Centers.  These were surveyed by NAMCS for the first time in 2006.

What are Community Health Centers?
Community Health Centers (CHCs) are local, non-profit, community-owned health care providers that serve low-income and medically underserved areas. Health centers serve as the medical home and family physician to over 15 million people nationally - a number that is quickly growing.  Health center patients are among the nation's most vulnerable populations - people who even if insured would nonetheless remain isolated from traditional forms of medical care because of where they live, who they are, the language they speak, and their higher levels of complex health care needs.  As a result, patients are disproportionately low income, uninsured or publicly insured, and minority.

Why include CHCs in the NAMCS?
Although general information is known about CHCs through the Uniform Data System (a mandatory reporting system within the Bureau of Primary Health Care, Health Resources and Services Administration), details of patient/physician encounters are not known.

Visits made to CHCs, although in-scope for the NAMCS, have been underrepresented in the survey because the normal sample of physicians is simply not large enough to capture many of the physicians who work at these important locations.

How does the NAMCS sample CHCs?
NAMCS includes three different types of CHCs in the sample: 1) CHCs that receive grant funds from the federal government through section 330 of the Public Service Act (PHSA), (2) Look-alike CHCs that meet all the requirements to receive 330 grant funding, but do not actually receive a grant, and (3) Urban Indian Federally Qualified Health Centers (FQHC).

Three providers at each of the 104 CHCs in the sample will be asked to participate. The resulting visits that are sampled from the 312 providers will enable NCHS to provide separate statistics on the visits made to CHCs.

Additionally, mid-level providers--nurse practitioners, physicians assistants, and nurse midwives--who work in CHCs are eligible to participate in the NAMCS.

bullet graphicNote on Oncologists
The separate stratum of oncologists that was sampled for 2006 and 2007 was not used in 2008 due to budgetary restrictions.

Confidentiality and Privacy

bullet graphicConfidentiality of NAMCS data
The NAMCS is conducted under the authority of Sec. 306 of the Public Health Service Act (42 USC 242k) which requires NCHS to collect statistics on a variety of health indicators. Information collected in this survey is used to study overall patterns of health care use by the population and for other similar statistical purposes. NCHS has a long history of protecting the privacy of information that we collect, and Sec. 308(d) of the Public Health Service Act (42 USC 242m) assures the confidentiality of data collected in the NAMCS. We strictly observe this confidentiality statute, which prohibits the release of identifiable information that we obtain unless we are given consent to do so by the subject.

HIPAA Privacy Rule and NAMCS
This section contains an overview of the Privacy Rule and how it affects your NAMCS participation.  For more comprehensive information on the Privacy Rule and the NAMCS, please go to HIPAA Privacy Rule Q’s and A’s for NAMCS.

The final Privacy Rule has been published as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  Health care providers who transmit financial and administrative health information electronically must comply with the Rule as of April 14, 2003.

The Privacy Rule permits you to make disclosures of protected health information without patient authorization for public health purposes or for research that has been approved by an Institutional Review Board (IRB).  This survey meets both of these criteria. Additionally, disclosures may be made under a data use agreement with NCHS.  If you have questions about your rights as a respondent, you may call the IRB at 1-800-223-8118.  The IRB is an independent board that protects the interests of people who take part in studies.  Click here to see the IRB approval letter for NAMCS.

We have included all the information you need to be assured that you are allowed to disclose protected health information for the NAMCS in our introductory letter to physicians, CHC directors, and CHC providers, and also here at our website.  However, there are several things that you must do to assure compliance with the Rule when participating in the survey. First, the privacy notice that you generally provide to your patients must indicate that patient information may be disclosed for either research or public health purposes.  And secondly, you may need to keep a record of the disclosure (which we will provide) that shows that some data from the patient’s medical record were disclosed to CDC for the NAMCS. Of course, if you do not transmit health information electronically (such as claims data), then you are not subject to the Privacy Rule or the requirements described above.

The Privacy Rule applies to data collected for the NAMCS because we are asking you to provide certain information about patients without their authorization.  For public health and research purposes, the NAMCS collects information from the patient's medical record such as visit date, birth date, and residential ZIP code.  While not directly identifiable, these data are considered protected health information as defined by the Privacy Rule.  As described above, the Rule allows you to disclose this information for public health and research purposes.

Please be assured that we fully intend to continue our long history of gaining the voluntary participation of providers like you by upholding the highest confidentiality standards and practices.

For additional information on the confidentiality of NAMCS data, please go to NCHS’s Privacy Protection page and Frequently Asked Questions (FAQ’s) about the NAMCS.

bullet graphicYour assurance of privacy
NCHS is legally bound to assure confidentiality of all responses, including any information that might result in a physician’s practice or hospital being identified. The data files that are released for research do not include any provider or patient identifying information.

The NAMCS does not collect any personally identifiable data about patients such as patient's name or address. The top section of the NAMCS Patient Record form, the survey instrument, contains a detachable section where hospital staff can record the patient's name for reference purposes. This section is detached prior to submission of the forms, and is kept by hospital staff for several weeks, in case it is necessary to retrieve missing information or clarify recorded information. Other information that may permit identification of an individual, a practice, or an establishment will be held confidential, will be used only by persons engaged in and for the purpose of the survey, and will not be disclosed or released to other persons or used for any other purpose without consent of the individual or the establishment in accordance with section 308(d) of the Public Health Service Act (42 USC 242m).

To see a copy of the NAMCS Patient Record form, click here.

Data Utilization

bullet graphicHow are NAMCS data used?
NAMCS data are used to provide statistics that describe the characteristics of office visits to physicians. These include patient demographic characteristics, the conditions most often treated, and the diagnostic and therapeutic services rendered, including medication prescribed. These data are used by public health policy makers, health services researchers, medical schools, physician associations, epidemiologists, and the print and broadcast media to describe and understand the changes that occur in medical care requirements and practices. The data are disseminated in the form of public health reports, journal articles, and microdata files.

bullet graphicNAMCS data in the news

bullet graphicAbout one in four doctors use some form of electronic medical records, suggesting that a technology frequently billed as a way to improve the quality and efficiency of care has yet to win widespread acceptance, according to a study released yesterday. -- Washington Post, October 12, 2006.

bullet graphicThe primary driver of electronic health record (EHR) adoption was practice size, with a clear linear relationship between practice size and EHR use. -- Electronic Health Record, October 2006.

bullet graphicIn the United States, medical visits rose 31 percent from 1994 to 2004.  Americans are seeking medical care in greater numbers than ever before, with the number of visits growing at nearly three times the rate of population growth, according to government statistics published yesterday. -- Washington Post, June 2006.

bullet graphicNAMCS Charts and Tables

bullet graphicPublications using NAMCS data

Professional Endorsements

This is truly a national resource. Without it, we would not have any reliable estimates of what happens at all the visits that Americans have with their doctors. -- Jim Rodgers, American Medical Association Vice president for Health Policy.

NAMCS is endorsed by many professional organizations. Here is a list of organizational endorsements:

bullet graphicAmerican Academy of Ambulatory Care Nursing Click to open pdf. file  133 KB

bullet graphicAmerican Academy of Dermatology Click here to open pdf. file 116 KB

bullet graphicAmerican Academy of Family Physicians Click here to open pdf. file  95 KB

bullet graphicAmerican Academy of Neurology Click here to open pdf. file 105 KB

bullet graphicAmerican Academy of Ophthalmology Click here to open pdf. file 94 KB

bullet graphicAmerican Academy of Orthopedic Surgeons Click here to open pdf. file 156 KB

bullet graphicAmerican Academy of Otolaryngology – Head and Neck Surgery, Inc Click here to open pdf. file 116 KB

bullet graphicAmerican Academy of Pediatrics Click here to open pdf. file 128 KB

bullet graphicAmerican Academy of Physical Medicine and Rehabilitation Click here to open pdf. file 116 KB

bullet graphicAmerican College of Cardiology Click here to open pdf. file 152 KB

bullet graphicAmerican College of Obstetricians and Gynecologists Click here to open pdf. file 152 KB

bullet graphicAmerican College of Physicians Click here to open pdf. file 117 KB

bullet graphicAmerican College of Preventive Medicine Click here to open pdf. file 223 KB

bullet graphicAmerican College of Surgeons Click here to open pdf. file 134 KB

bullet graphicAmerican Osteopathic Association Click here to open pdf. file 2 MB

bullet graphicAmerican Psychiatric Association Click here to open pdf. file 153 KB

bullet graphicAmerican Society of Clinical Oncology Click here to open pdf. file 128 KB

bullet graphicAmerican Society of Plastic Surgeons Click here to open pdf. file 344 KB

bullet graphicAmerican Urological Association Click here to open pdf. file 139 KB

bullet graphicAssociation of American Medical Colleges Click here to open pdf. file 31 KB

bullet graphicNational Association of Community Health Centers Click here to open pdf. file 252 KB

Contact Information

If you have any further questions or comments related to participation, please contact David Woodwell at:

National Center for Health Statistics
Ambulatory Care Statistics Branch
3311 Toledo Road, Room 3409
Hyattsville, Maryland 20782
Phone: 800-392-2862
Fax: 301-458-4032
Ambulatory Health Care Data home page

NAMCS/NHAMCS Home | NAMCS Participants
CDC/NCHS Privacy Policy Notice | Accessibility
CDC/NCHS Privacy Policy Notice | Accessibility | Site Index
Search NCHS | NCHS Home | Contact Us
For more information, contact the Ambulatory Care Statistics Branch at (301) 458-4600


CDC Home | Search | Health Topics A-Z

This page last reviewed August 20, 2008

H H S Health and Human Services logo and link
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
National Center for Health Statistics
Hyattsville, MD
20782

1-800-232-4636