Although physician surveys are an important tool in health services and policy research, they are often characterized by low response rates. The authors conducted a systematic review of 66 published reports of efforts to improve response rates to physician surveys. Two general strategies were explored in this literature: incentive and design-based approaches. Even small financial incentives were found to be effective in improving physician response. Token nonmonetary incentives were much less effective. In terms of design strategies, postal and telephone strategies have generally been more successful than have fax or Web-based approaches, with evidence also supporting use of mixed-mode surveys in this population. In addition, use of first-class stamps on return envelopes and questionnaires designed to be brief, personalized, and endorsed by legitimizing professional associations were also more likely to be successful. Researchers should continue to implement design strategies that have been documented to improve the survey response of physicians.

Surveys involving health care providers are characterized by low and declining response rates (RRs), and researchers have utilized various strategies to increase survey RRs among health professionals. Based on 48 studies with 156 subgroups of within-study conditions, a multilevel meta-regression analysis was conducted to summarize the effects of different strategies employed in surveys of health professionals. An estimated overall survey RR among health professionals was 0.53 with a significant downward trend during the last half century. Of the variables that were examined, mode of data collection, incentives, and number of follow-up attempts were all found to be significantly related to RR. The mail survey mode was more effective in improving RR, compared to the online or web survey mode. Relative to the non-incentive subgroups, subgroups receiving monetary incentives were more likely to respond, while nonmonetary incentive groups were not significantly different from non-incentive groups. When number of follow-ups was considered, the one or two attempts of follow-up were found to be effective in increasing survey RR among health professionals. Having noted challenges associated with surveying health professionals, researchers must make every effort to improve access to their target population by implementing appropriate incentive- and design-based strategies demonstrated to improve participation rates.

These results suggest that racial and ethnic disparities, independent of SES, exist in selected areas of adolescent health care. More studies are needed to better understand the extent and causes of these findings.

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A sizable minority of physicians report manipulating reimbursement rules so patients can receive care that physicians perceive is necessary. Unless novel strategies are developed to address this, greater utilization restrictions in the health care system are likely to increase physicians' use of such manipulative "covert advocacy" tactics.