Study the asymmetry of the edges in the specialty referral matrix.

We are studying a small graph, where each node is a primary specialty (e.g. PREVENTATIVE MEDICINE). Then, an “edge” from one specialty to another specialty represents a referral from a doctor of the first type, to a doctor of the second type. In a sample of 100k edges, there were 74 unique primary specialties. To accumulate edge strength, I used “two logs” as was done in the zip code graph. You can see my code here. You can download the data from the following url.

rm(list = ls())
library(Matrix)
library(igraph)
load(url("http://pages.stat.wisc.edu/~karlrohe/netsci/data/specialty.RData"))
A = as.matrix(A) # it used to be a sparse matrix "dgCMatrix", even though it isn't that sparse. 
rs = rowSums(A); cs = colSums(A)
plot(rs,cs, xlab= "out degree", ylab = "in degree", col = "white")
text(rs, cs, labels=colnames(A), cex = .5)

ors = order(rs)
cbind(colnames(A)[ors], round(rs[ors],1))
##                                                [,1]                                            
## CERTIFIED NURSE MIDWIFE                        "CERTIFIED NURSE MIDWIFE"                       
## ORAL SURGERY (DENTIST ONLY)                    "ORAL SURGERY (DENTIST ONLY)"                   
## REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL "REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL"
## SPEECH LANGUAGE PATHOLOGIST                    "SPEECH LANGUAGE PATHOLOGIST"                   
## ADDICTION MEDICINE                             "ADDICTION MEDICINE"                            
## GERIATRIC PSYCHIATRY                           "GERIATRIC PSYCHIATRY"                          
## PREVENTATIVE MEDICINE                          "PREVENTATIVE MEDICINE"                         
## GYNECOLOGICAL ONCOLOGY                         "GYNECOLOGICAL ONCOLOGY"                        
## NEUROPSYCHIATRY                                "NEUROPSYCHIATRY"                               
## SPORTS MEDICINE                                "SPORTS MEDICINE"                               
## SLEEP LABORATORY/MEDICINE                      "SLEEP LABORATORY/MEDICINE"                     
## PERIPHERAL VASCULAR DISEASE                    "PERIPHERAL VASCULAR DISEASE"                   
## OSTEOPATHIC MANIPULATIVE MEDICINE              "OSTEOPATHIC MANIPULATIVE MEDICINE"             
## SURGICAL ONCOLOGY                              "SURGICAL ONCOLOGY"                             
## HOSPICE/PALLIATIVE CARE                        "HOSPICE/PALLIATIVE CARE"                       
## AUDIOLOGIST                                    "AUDIOLOGIST"                                   
## HAND SURGERY                                   "HAND SURGERY"                                  
## ANESTHESIOLOGY ASSISTANT                       "ANESTHESIOLOGY ASSISTANT"                      
## OCCUPATIONAL THERAPY                           "OCCUPATIONAL THERAPY"                          
## CLINICAL NURSE SPECIALIST                      "CLINICAL NURSE SPECIALIST"                     
## PEDIATRIC MEDICINE                             "PEDIATRIC MEDICINE"                            
## ALLERGY/IMMUNOLOGY                             "ALLERGY/IMMUNOLOGY"                            
## PHYSICIAN ASSISTANT                            "PHYSICIAN ASSISTANT"                           
## COLORECTAL SURGERY (PROCTOLOGY)                "COLORECTAL SURGERY (PROCTOLOGY)"               
## CLINICAL SOCIAL WORKER                         "CLINICAL SOCIAL WORKER"                        
## PLASTIC AND RECONSTRUCTIVE SURGERY             "PLASTIC AND RECONSTRUCTIVE SURGERY"            
## CHIROPRACTIC                                   "CHIROPRACTIC"                                  
## OBSTETRICS/GYNECOLOGY                          "OBSTETRICS/GYNECOLOGY"                         
## HEMATOLOGY                                     "HEMATOLOGY"                                    
## UNDEFINED PHYSICIAN TYPE (SPECIFY)             "UNDEFINED PHYSICIAN TYPE (SPECIFY)"            
## PHYSICAL THERAPY                               "PHYSICAL THERAPY"                              
## INTERVENTIONAL PAIN MANAGEMENT                 "INTERVENTIONAL PAIN MANAGEMENT"                
## PAIN MANAGEMENT                                "PAIN MANAGEMENT"                               
## CLINICAL PSYCHOLOGIST                          "CLINICAL PSYCHOLOGIST"                         
## NEUROSURGERY                                   "NEUROSURGERY"                                  
## RADIATION ONCOLOGY                             "RADIATION ONCOLOGY"                            
## NUCLEAR MEDICINE                               "NUCLEAR MEDICINE"                              
## GERIATRIC MEDICINE                             "GERIATRIC MEDICINE"                            
## CARDIAC SURGERY                                "CARDIAC SURGERY"                               
## GENERAL PRACTICE                               "GENERAL PRACTICE"                              
## RHEUMATOLOGY                                   "RHEUMATOLOGY"                                  
## THORACIC SURGERY                               "THORACIC SURGERY"                              
## OPTOMETRY                                      "OPTOMETRY"                                     
## MEDICAL ONCOLOGY                               "MEDICAL ONCOLOGY"                              
## OTOLARYNGOLOGY                                 "OTOLARYNGOLOGY"                                
## ENDOCRINOLOGY                                  "ENDOCRINOLOGY"                                 
## CERTIFIED REGISTERED NURSE ANESTHETIST         "CERTIFIED REGISTERED NURSE ANESTHETIST"        
## CRITICAL CARE (INTENSIVISTS)                   "CRITICAL CARE (INTENSIVISTS)"                  
## PSYCHIATRY                                     "PSYCHIATRY"                                    
## DERMATOLOGY                                    "DERMATOLOGY"                                   
## PHYSICAL MEDICINE AND REHABILITATION           "PHYSICAL MEDICINE AND REHABILITATION"          
## VASCULAR SURGERY                               "VASCULAR SURGERY"                              
## UROLOGY                                        "UROLOGY"                                       
## INTERVENTIONAL RADIOLOGY                       "INTERVENTIONAL RADIOLOGY"                      
## ORTHOPEDIC SURGERY                             "ORTHOPEDIC SURGERY"                            
## CARDIAC ELECTROPHYSIOLOGY                      "CARDIAC ELECTROPHYSIOLOGY"                     
## HEMATOLOGY/ONCOLOGY                            "HEMATOLOGY/ONCOLOGY"                           
## OPHTHALMOLOGY                                  "OPHTHALMOLOGY"                                 
## NEUROLOGY                                      "NEUROLOGY"                                     
## INFECTIOUS DISEASE                             "INFECTIOUS DISEASE"                            
## GENERAL SURGERY                                "GENERAL SURGERY"                               
## GASTROENTEROLOGY                               "GASTROENTEROLOGY"                              
## ANESTHESIOLOGY                                 "ANESTHESIOLOGY"                                
## INTERVENTIONAL CARDIOLOGY                      "INTERVENTIONAL CARDIOLOGY"                     
## PODIATRY                                       "PODIATRY"                                      
## EMERGENCY MEDICINE                             "EMERGENCY MEDICINE"                            
## NEPHROLOGY                                     "NEPHROLOGY"                                    
## PATHOLOGY                                      "PATHOLOGY"                                     
## NURSE PRACTITIONER                             "NURSE PRACTITIONER"                            
## PULMONARY DISEASE                              "PULMONARY DISEASE"                             
## FAMILY PRACTICE                                "FAMILY PRACTICE"                               
## CARDIOVASCULAR DISEASE (CARDIOLOGY)            "CARDIOVASCULAR DISEASE (CARDIOLOGY)"           
## INTERNAL MEDICINE                              "INTERNAL MEDICINE"                             
## DIAGNOSTIC RADIOLOGY                           "DIAGNOSTIC RADIOLOGY"                          
##                                                [,2]   
## CERTIFIED NURSE MIDWIFE                        "0"    
## ORAL SURGERY (DENTIST ONLY)                    "0"    
## REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL "0.1"  
## SPEECH LANGUAGE PATHOLOGIST                    "0.1"  
## ADDICTION MEDICINE                             "0.2"  
## GERIATRIC PSYCHIATRY                           "0.3"  
## PREVENTATIVE MEDICINE                          "0.3"  
## GYNECOLOGICAL ONCOLOGY                         "0.5"  
## NEUROPSYCHIATRY                                "0.9"  
## SPORTS MEDICINE                                "1.2"  
## SLEEP LABORATORY/MEDICINE                      "1.3"  
## PERIPHERAL VASCULAR DISEASE                    "2"    
## OSTEOPATHIC MANIPULATIVE MEDICINE              "2.5"  
## SURGICAL ONCOLOGY                              "2.7"  
## HOSPICE/PALLIATIVE CARE                        "3"    
## AUDIOLOGIST                                    "3.2"  
## HAND SURGERY                                   "3.3"  
## ANESTHESIOLOGY ASSISTANT                       "3.4"  
## OCCUPATIONAL THERAPY                           "3.7"  
## CLINICAL NURSE SPECIALIST                      "3.7"  
## PEDIATRIC MEDICINE                             "3.9"  
## ALLERGY/IMMUNOLOGY                             "4.4"  
## PHYSICIAN ASSISTANT                            "5"    
## COLORECTAL SURGERY (PROCTOLOGY)                "5.7"  
## CLINICAL SOCIAL WORKER                         "6.2"  
## PLASTIC AND RECONSTRUCTIVE SURGERY             "6.4"  
## CHIROPRACTIC                                   "7.7"  
## OBSTETRICS/GYNECOLOGY                          "8.1"  
## HEMATOLOGY                                     "9.6"  
## UNDEFINED PHYSICIAN TYPE (SPECIFY)             "10.9" 
## PHYSICAL THERAPY                               "11.7" 
## INTERVENTIONAL PAIN MANAGEMENT                 "11.8" 
## PAIN MANAGEMENT                                "12"   
## CLINICAL PSYCHOLOGIST                          "15.3" 
## NEUROSURGERY                                   "15.3" 
## RADIATION ONCOLOGY                             "17.1" 
## NUCLEAR MEDICINE                               "17.4" 
## GERIATRIC MEDICINE                             "18.1" 
## CARDIAC SURGERY                                "18.7" 
## GENERAL PRACTICE                               "18.8" 
## RHEUMATOLOGY                                   "18.9" 
## THORACIC SURGERY                               "20.6" 
## OPTOMETRY                                      "21.8" 
## MEDICAL ONCOLOGY                               "24.2" 
## OTOLARYNGOLOGY                                 "29"   
## ENDOCRINOLOGY                                  "33.4" 
## CERTIFIED REGISTERED NURSE ANESTHETIST         "34.1" 
## CRITICAL CARE (INTENSIVISTS)                   "34.2" 
## PSYCHIATRY                                     "41.6" 
## DERMATOLOGY                                    "42"   
## PHYSICAL MEDICINE AND REHABILITATION           "42.3" 
## VASCULAR SURGERY                               "47.1" 
## UROLOGY                                        "48.8" 
## INTERVENTIONAL RADIOLOGY                       "50"   
## ORTHOPEDIC SURGERY                             "50.4" 
## CARDIAC ELECTROPHYSIOLOGY                      "55.2" 
## HEMATOLOGY/ONCOLOGY                            "56.4" 
## OPHTHALMOLOGY                                  "56.4" 
## NEUROLOGY                                      "56.6" 
## INFECTIOUS DISEASE                             "57.6" 
## GENERAL SURGERY                                "62.4" 
## GASTROENTEROLOGY                               "63.2" 
## ANESTHESIOLOGY                                 "63.5" 
## INTERVENTIONAL CARDIOLOGY                      "66.5" 
## PODIATRY                                       "68.1" 
## EMERGENCY MEDICINE                             "79.6" 
## NEPHROLOGY                                     "83.3" 
## PATHOLOGY                                      "96.2" 
## NURSE PRACTITIONER                             "97.4" 
## PULMONARY DISEASE                              "103.4"
## FAMILY PRACTICE                                "125.6"
## CARDIOVASCULAR DISEASE (CARDIOLOGY)            "168"  
## INTERNAL MEDICINE                              "181"  
## DIAGNOSTIC RADIOLOGY                           "242.9"

Are edges reciprocal?

plot(A,t(A), main = "non-reciprocated edges at low degrees.")

bA = matrix(0, nrow = nrow(A), ncol = ncol(A))
bA[A>.5] = 1
nonrecA = bA*(1-t(bA))
nonrecEdges = which(nonrecA == 1, arr.ind = T)
# the first column makes some referrals to the second column, but it is much less likely in the other direction.
cbind(colnames(A)[nonrecEdges[,1]], colnames(A)[nonrecEdges[,2]])
##        [,1]                                    
##   [1,] "NURSE PRACTITIONER"                    
##   [2,] "GASTROENTEROLOGY"                      
##   [3,] "PLASTIC AND RECONSTRUCTIVE SURGERY"    
##   [4,] "CLINICAL SOCIAL WORKER"                
##   [5,] "PAIN MANAGEMENT"                       
##   [6,] "DERMATOLOGY"                           
##   [7,] "PERIPHERAL VASCULAR DISEASE"           
##   [8,] "OSTEOPATHIC MANIPULATIVE MEDICINE"     
##   [9,] "SPORTS MEDICINE"                       
##  [10,] "PLASTIC AND RECONSTRUCTIVE SURGERY"    
##  [11,] "COLORECTAL SURGERY (PROCTOLOGY)"       
##  [12,] "HEMATOLOGY"                            
##  [13,] "CLINICAL SOCIAL WORKER"                
##  [14,] "SURGICAL ONCOLOGY"                     
##  [15,] "RADIATION ONCOLOGY"                    
##  [16,] "COLORECTAL SURGERY (PROCTOLOGY)"       
##  [17,] "NEUROLOGY"                             
##  [18,] "HAND SURGERY"                          
##  [19,] "PERIPHERAL VASCULAR DISEASE"           
##  [20,] "NEUROPSYCHIATRY"                       
##  [21,] "PEDIATRIC MEDICINE"                    
##  [22,] "UROLOGY"                               
##  [23,] "ENDOCRINOLOGY"                         
##  [24,] "GENERAL PRACTICE"                      
##  [25,] "OTOLARYNGOLOGY"                        
##  [26,] "INTERVENTIONAL PAIN MANAGEMENT"        
##  [27,] "ENDOCRINOLOGY"                         
##  [28,] "NEUROSURGERY"                          
##  [29,] "NUCLEAR MEDICINE"                      
##  [30,] "COLORECTAL SURGERY (PROCTOLOGY)"       
##  [31,] "HEMATOLOGY"                            
##  [32,] "CARDIAC SURGERY"                       
##  [33,] "ORTHOPEDIC SURGERY"                    
##  [34,] "DERMATOLOGY"                           
##  [35,] "MEDICAL ONCOLOGY"                      
##  [36,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
##  [37,] "FAMILY PRACTICE"                       
##  [38,] "INTERVENTIONAL CARDIOLOGY"             
##  [39,] "CARDIAC ELECTROPHYSIOLOGY"             
##  [40,] "THORACIC SURGERY"                      
##  [41,] "OPHTHALMOLOGY"                         
##  [42,] "THORACIC SURGERY"                      
##  [43,] "NUCLEAR MEDICINE"                      
##  [44,] "CARDIAC SURGERY"                       
##  [45,] "THORACIC SURGERY"                      
##  [46,] "RADIATION ONCOLOGY"                    
##  [47,] "NUCLEAR MEDICINE"                      
##  [48,] "OTOLARYNGOLOGY"                        
##  [49,] "HEMATOLOGY"                            
##  [50,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [51,] "CARDIAC ELECTROPHYSIOLOGY"             
##  [52,] "PODIATRY"                              
##  [53,] "VASCULAR SURGERY"                      
##  [54,] "UROLOGY"                               
##  [55,] "CARDIAC ELECTROPHYSIOLOGY"             
##  [56,] "ENDOCRINOLOGY"                         
##  [57,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
##  [58,] "PLASTIC AND RECONSTRUCTIVE SURGERY"    
##  [59,] "PAIN MANAGEMENT"                       
##  [60,] "EMERGENCY MEDICINE"                    
##  [61,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [62,] "INTERVENTIONAL CARDIOLOGY"             
##  [63,] "CARDIAC ELECTROPHYSIOLOGY"             
##  [64,] "THORACIC SURGERY"                      
##  [65,] "CRITICAL CARE (INTENSIVISTS)"          
##  [66,] "PSYCHIATRY"                            
##  [67,] "INTERVENTIONAL PAIN MANAGEMENT"        
##  [68,] "ALLERGY/IMMUNOLOGY"                    
##  [69,] "NEUROSURGERY"                          
##  [70,] "PSYCHIATRY"                            
##  [71,] "EMERGENCY MEDICINE"                    
##  [72,] "VASCULAR SURGERY"                      
##  [73,] "UROLOGY"                               
##  [74,] "GASTROENTEROLOGY"                      
##  [75,] "INTERVENTIONAL CARDIOLOGY"             
##  [76,] "PHYSICAL THERAPY"                      
##  [77,] "ENDOCRINOLOGY"                         
##  [78,] "ANESTHESIOLOGY"                        
##  [79,] "HEMATOLOGY/ONCOLOGY"                   
##  [80,] "NEUROSURGERY"                          
##  [81,] "NUCLEAR MEDICINE"                      
##  [82,] "PSYCHIATRY"                            
##  [83,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
##  [84,] "DERMATOLOGY"                           
##  [85,] "EMERGENCY MEDICINE"                    
##  [86,] "INFECTIOUS DISEASE"                    
##  [87,] "INTERVENTIONAL CARDIOLOGY"             
##  [88,] "GENERAL PRACTICE"                      
##  [89,] "PHYSICIAN ASSISTANT"                   
##  [90,] "ORTHOPEDIC SURGERY"                    
##  [91,] "DIAGNOSTIC RADIOLOGY"                  
##  [92,] "NEUROLOGY"                             
##  [93,] "ANESTHESIOLOGY"                        
##  [94,] "GERIATRIC MEDICINE"                    
##  [95,] "VASCULAR SURGERY"                      
##  [96,] "EMERGENCY MEDICINE"                    
##  [97,] "VASCULAR SURGERY"                      
##  [98,] "INTERVENTIONAL CARDIOLOGY"             
##  [99,] "CARDIAC ELECTROPHYSIOLOGY"             
## [100,] "HEMATOLOGY/ONCOLOGY"                   
## [101,] "EMERGENCY MEDICINE"                    
## [102,] "THORACIC SURGERY"                      
## [103,] "NUCLEAR MEDICINE"                      
## [104,] "HAND SURGERY"                          
## [105,] "ANESTHESIOLOGY ASSISTANT"              
## [106,] "PAIN MANAGEMENT"                       
## [107,] "NEUROLOGY"                             
## [108,] "INTERVENTIONAL RADIOLOGY"              
## [109,] "INTERVENTIONAL CARDIOLOGY"             
## [110,] "ANESTHESIOLOGY"                        
## [111,] "RHEUMATOLOGY"                          
## [112,] "OTOLARYNGOLOGY"                        
## [113,] "ORTHOPEDIC SURGERY"                    
## [114,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
## [115,] "PATHOLOGY"                             
## [116,] "CARDIAC ELECTROPHYSIOLOGY"             
## [117,] "NURSE PRACTITIONER"                    
## [118,] "UROLOGY"                               
## [119,] "GASTROENTEROLOGY"                      
## [120,] "INTERVENTIONAL CARDIOLOGY"             
## [121,] "PATHOLOGY"                             
## [122,] "NURSE PRACTITIONER"                    
## [123,] "RHEUMATOLOGY"                          
## [124,] "EMERGENCY MEDICINE"                    
## [125,] "PATHOLOGY"                             
## [126,] "UROLOGY"                               
## [127,] "GASTROENTEROLOGY"                      
## [128,] "OPHTHALMOLOGY"                         
## [129,] "NEPHROLOGY"                            
## [130,] "PULMONARY DISEASE"                     
## [131,] "GENERAL SURGERY"                       
## [132,] "CHIROPRACTIC"                          
## [133,] "ORTHOPEDIC SURGERY"                    
## [134,] "INTERVENTIONAL PAIN MANAGEMENT"        
## [135,] "EMERGENCY MEDICINE"                    
## [136,] "VASCULAR SURGERY"                      
## [137,] "ANESTHESIOLOGY"                        
## [138,] "HEMATOLOGY/ONCOLOGY"                   
## [139,] "INTERVENTIONAL RADIOLOGY"              
## [140,] "DERMATOLOGY"                           
## [141,] "GENERAL SURGERY"                       
## [142,] "OTOLARYNGOLOGY"                        
## [143,] "GASTROENTEROLOGY"                      
## [144,] "ENDOCRINOLOGY"                         
## [145,] "INTERNAL MEDICINE"                     
## [146,] "CARDIOVASCULAR DISEASE (CARDIOLOGY)"   
## [147,] "NURSE PRACTITIONER"                    
## [148,] "EMERGENCY MEDICINE"                    
## [149,] "VASCULAR SURGERY"                      
## [150,] "FAMILY PRACTICE"                       
## [151,] "ENDOCRINOLOGY"                         
## [152,] "ANESTHESIOLOGY"                        
## [153,] "RHEUMATOLOGY"                          
## [154,] "FAMILY PRACTICE"                       
## [155,] "PULMONARY DISEASE"                     
## [156,] "CARDIAC ELECTROPHYSIOLOGY"             
## [157,] "ANESTHESIOLOGY"                        
## [158,] "CARDIOVASCULAR DISEASE (CARDIOLOGY)"   
## [159,] "DIAGNOSTIC RADIOLOGY"                  
## [160,] "DIAGNOSTIC RADIOLOGY"                  
## [161,] "INTERNAL MEDICINE"                     
## [162,] "DIAGNOSTIC RADIOLOGY"                  
## [163,] "FAMILY PRACTICE"                       
## [164,] "OPHTHALMOLOGY"                         
## [165,] "EMERGENCY MEDICINE"                    
## [166,] "GASTROENTEROLOGY"                      
## [167,] "CARDIAC ELECTROPHYSIOLOGY"             
## [168,] "GENERAL SURGERY"                       
## [169,] "PSYCHIATRY"                            
## [170,] "DERMATOLOGY"                           
## [171,] "INTERVENTIONAL CARDIOLOGY"             
## [172,] "INTERNAL MEDICINE"                     
## [173,] "OPHTHALMOLOGY"                         
## [174,] "CARDIOVASCULAR DISEASE (CARDIOLOGY)"   
## [175,] "PATHOLOGY"                             
## [176,] "ORTHOPEDIC SURGERY"                    
## [177,] "ORTHOPEDIC SURGERY"                    
## [178,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
## [179,] "CARDIOVASCULAR DISEASE (CARDIOLOGY)"   
## [180,] "PATHOLOGY"                             
## [181,] "INTERNAL MEDICINE"                     
## [182,] "INTERNAL MEDICINE"                     
## [183,] "INTERVENTIONAL PAIN MANAGEMENT"        
## [184,] "INTERNAL MEDICINE"                     
## [185,] "NEPHROLOGY"                            
## [186,] "INTERNAL MEDICINE"                     
## [187,] "DIAGNOSTIC RADIOLOGY"                  
##        [,2]                                    
##   [1,] "OPHTHALMOLOGY"                         
##   [2,] "OPHTHALMOLOGY"                         
##   [3,] "PODIATRY"                              
##   [4,] "PODIATRY"                              
##   [5,] "PODIATRY"                              
##   [6,] "EMERGENCY MEDICINE"                    
##   [7,] "EMERGENCY MEDICINE"                    
##   [8,] "INTERNAL MEDICINE"                     
##   [9,] "INTERNAL MEDICINE"                     
##  [10,] "INTERNAL MEDICINE"                     
##  [11,] "INTERNAL MEDICINE"                     
##  [12,] "INTERNAL MEDICINE"                     
##  [13,] "INTERNAL MEDICINE"                     
##  [14,] "INTERNAL MEDICINE"                     
##  [15,] "CARDIOVASCULAR DISEASE (CARDIOLOGY)"   
##  [16,] "CARDIOVASCULAR DISEASE (CARDIOLOGY)"   
##  [17,] "VASCULAR SURGERY"                      
##  [18,] "DIAGNOSTIC RADIOLOGY"                  
##  [19,] "DIAGNOSTIC RADIOLOGY"                  
##  [20,] "DIAGNOSTIC RADIOLOGY"                  
##  [21,] "DIAGNOSTIC RADIOLOGY"                  
##  [22,] "NEUROLOGY"                             
##  [23,] "NEUROLOGY"                             
##  [24,] "NEUROLOGY"                             
##  [25,] "NEUROLOGY"                             
##  [26,] "NEUROLOGY"                             
##  [27,] "PATHOLOGY"                             
##  [28,] "PATHOLOGY"                             
##  [29,] "PATHOLOGY"                             
##  [30,] "PATHOLOGY"                             
##  [31,] "PATHOLOGY"                             
##  [32,] "NEPHROLOGY"                            
##  [33,] "NEPHROLOGY"                            
##  [34,] "NEPHROLOGY"                            
##  [35,] "NEPHROLOGY"                            
##  [36,] "NEPHROLOGY"                            
##  [37,] "CARDIAC SURGERY"                       
##  [38,] "CARDIAC SURGERY"                       
##  [39,] "CARDIAC SURGERY"                       
##  [40,] "CARDIAC SURGERY"                       
##  [41,] "INTERVENTIONAL RADIOLOGY"              
##  [42,] "INTERVENTIONAL RADIOLOGY"              
##  [43,] "INTERVENTIONAL RADIOLOGY"              
##  [44,] "NURSE PRACTITIONER"                    
##  [45,] "NURSE PRACTITIONER"                    
##  [46,] "NURSE PRACTITIONER"                    
##  [47,] "NURSE PRACTITIONER"                    
##  [48,] "NURSE PRACTITIONER"                    
##  [49,] "NURSE PRACTITIONER"                    
##  [50,] "UROLOGY"                               
##  [51,] "UROLOGY"                               
##  [52,] "GASTROENTEROLOGY"                      
##  [53,] "GASTROENTEROLOGY"                      
##  [54,] "GASTROENTEROLOGY"                      
##  [55,] "GASTROENTEROLOGY"                      
##  [56,] "GASTROENTEROLOGY"                      
##  [57,] "GASTROENTEROLOGY"                      
##  [58,] "GASTROENTEROLOGY"                      
##  [59,] "GASTROENTEROLOGY"                      
##  [60,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [61,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [62,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [63,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [64,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [65,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [66,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [67,] "CERTIFIED REGISTERED NURSE ANESTHETIST"
##  [68,] "PULMONARY DISEASE"                     
##  [69,] "PULMONARY DISEASE"                     
##  [70,] "PULMONARY DISEASE"                     
##  [71,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [72,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [73,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [74,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [75,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [76,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [77,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [78,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [79,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [80,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [81,] "PHYSICAL MEDICINE AND REHABILITATION"  
##  [82,] "INFECTIOUS DISEASE"                    
##  [83,] "INFECTIOUS DISEASE"                    
##  [84,] "INTERVENTIONAL CARDIOLOGY"             
##  [85,] "ORTHOPEDIC SURGERY"                    
##  [86,] "ORTHOPEDIC SURGERY"                    
##  [87,] "ORTHOPEDIC SURGERY"                    
##  [88,] "ORTHOPEDIC SURGERY"                    
##  [89,] "ORTHOPEDIC SURGERY"                    
##  [90,] "DERMATOLOGY"                           
##  [91,] "PHYSICAL THERAPY"                      
##  [92,] "OPTOMETRY"                             
##  [93,] "OPTOMETRY"                             
##  [94,] "OPTOMETRY"                             
##  [95,] "CARDIAC ELECTROPHYSIOLOGY"             
##  [96,] "ENDOCRINOLOGY"                         
##  [97,] "ENDOCRINOLOGY"                         
##  [98,] "ENDOCRINOLOGY"                         
##  [99,] "ENDOCRINOLOGY"                         
## [100,] "ENDOCRINOLOGY"                         
## [101,] "ANESTHESIOLOGY"                        
## [102,] "ANESTHESIOLOGY"                        
## [103,] "ANESTHESIOLOGY"                        
## [104,] "ANESTHESIOLOGY"                        
## [105,] "ANESTHESIOLOGY"                        
## [106,] "ANESTHESIOLOGY"                        
## [107,] "HEMATOLOGY/ONCOLOGY"                   
## [108,] "HEMATOLOGY/ONCOLOGY"                   
## [109,] "HEMATOLOGY/ONCOLOGY"                   
## [110,] "HEMATOLOGY/ONCOLOGY"                   
## [111,] "HEMATOLOGY/ONCOLOGY"                   
## [112,] "HEMATOLOGY/ONCOLOGY"                   
## [113,] "GENERAL SURGERY"                       
## [114,] "GENERAL SURGERY"                       
## [115,] "THORACIC SURGERY"                      
## [116,] "THORACIC SURGERY"                      
## [117,] "RHEUMATOLOGY"                          
## [118,] "RHEUMATOLOGY"                          
## [119,] "RHEUMATOLOGY"                          
## [120,] "RHEUMATOLOGY"                          
## [121,] "ALLERGY/IMMUNOLOGY"                    
## [122,] "ALLERGY/IMMUNOLOGY"                    
## [123,] "ALLERGY/IMMUNOLOGY"                    
## [124,] "RADIATION ONCOLOGY"                    
## [125,] "RADIATION ONCOLOGY"                    
## [126,] "RADIATION ONCOLOGY"                    
## [127,] "RADIATION ONCOLOGY"                    
## [128,] "GENERAL PRACTICE"                      
## [129,] "GENERAL PRACTICE"                      
## [130,] "GENERAL PRACTICE"                      
## [131,] "GENERAL PRACTICE"                      
## [132,] "GENERAL PRACTICE"                      
## [133,] "NEUROSURGERY"                          
## [134,] "NEUROSURGERY"                          
## [135,] "CRITICAL CARE (INTENSIVISTS)"          
## [136,] "CRITICAL CARE (INTENSIVISTS)"          
## [137,] "CRITICAL CARE (INTENSIVISTS)"          
## [138,] "CRITICAL CARE (INTENSIVISTS)"          
## [139,] "PSYCHIATRY"                            
## [140,] "PSYCHIATRY"                            
## [141,] "PSYCHIATRY"                            
## [142,] "PSYCHIATRY"                            
## [143,] "MEDICAL ONCOLOGY"                      
## [144,] "MEDICAL ONCOLOGY"                      
## [145,] "HOSPICE/PALLIATIVE CARE"               
## [146,] "HOSPICE/PALLIATIVE CARE"               
## [147,] "CHIROPRACTIC"                          
## [148,] "NUCLEAR MEDICINE"                      
## [149,] "NUCLEAR MEDICINE"                      
## [150,] "NUCLEAR MEDICINE"                      
## [151,] "OTOLARYNGOLOGY"                        
## [152,] "OTOLARYNGOLOGY"                        
## [153,] "OTOLARYNGOLOGY"                        
## [154,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
## [155,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
## [156,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
## [157,] "UNDEFINED PHYSICIAN TYPE (SPECIFY)"    
## [158,] "PERIPHERAL VASCULAR DISEASE"           
## [159,] "GYNECOLOGICAL ONCOLOGY"                
## [160,] "SPORTS MEDICINE"                       
## [161,] "SLEEP LABORATORY/MEDICINE"             
## [162,] "SLEEP LABORATORY/MEDICINE"             
## [163,] "SLEEP LABORATORY/MEDICINE"             
## [164,] "GERIATRIC MEDICINE"                    
## [165,] "GERIATRIC MEDICINE"                    
## [166,] "GERIATRIC MEDICINE"                    
## [167,] "GERIATRIC MEDICINE"                    
## [168,] "GERIATRIC MEDICINE"                    
## [169,] "GERIATRIC MEDICINE"                    
## [170,] "PLASTIC AND RECONSTRUCTIVE SURGERY"    
## [171,] "CLINICAL PSYCHOLOGIST"                 
## [172,] "OBSTETRICS/GYNECOLOGY"                 
## [173,] "INTERVENTIONAL PAIN MANAGEMENT"        
## [174,] "INTERVENTIONAL PAIN MANAGEMENT"        
## [175,] "INTERVENTIONAL PAIN MANAGEMENT"        
## [176,] "INTERVENTIONAL PAIN MANAGEMENT"        
## [177,] "OCCUPATIONAL THERAPY"                  
## [178,] "OCCUPATIONAL THERAPY"                  
## [179,] "HEMATOLOGY"                            
## [180,] "ANESTHESIOLOGY ASSISTANT"              
## [181,] "NEUROPSYCHIATRY"                       
## [182,] "PAIN MANAGEMENT"                       
## [183,] "PAIN MANAGEMENT"                       
## [184,] "PHYSICIAN ASSISTANT"                   
## [185,] "PEDIATRIC MEDICINE"                    
## [186,] "GERIATRIC PSYCHIATRY"                  
## [187,] "CERTIFIED NURSE MIDWIFE"

What is the page rank? Imagine a Markov chain on the specialties. You get randomly referred around this network. Where are you likely to land?

g= graph.adjacency(A,mode= "directed", weighted = T)
pr = page.rank(g,directed = T)
sort(pr$vec)
##                    SPEECH LANGUAGE PATHOLOGIST 
##                                    0.002077967 
##                             ADDICTION MEDICINE 
##                                    0.002105919 
##                    ORAL SURGERY (DENTIST ONLY) 
##                                    0.002107728 
## REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL 
##                                    0.002161430 
##                          PREVENTATIVE MEDICINE 
##                                    0.002179199 
##                        CERTIFIED NURSE MIDWIFE 
##                                    0.002327073 
##                    PERIPHERAL VASCULAR DISEASE 
##                                    0.002422320 
##                                NEUROPSYCHIATRY 
##                                    0.002462197 
##              OSTEOPATHIC MANIPULATIVE MEDICINE 
##                                    0.002475945 
##                                   HAND SURGERY 
##                                    0.002507377 
##                                SPORTS MEDICINE 
##                                    0.002525492 
##                           GERIATRIC PSYCHIATRY 
##                                    0.002684366 
##                COLORECTAL SURGERY (PROCTOLOGY) 
##                                    0.002708545 
##                             PEDIATRIC MEDICINE 
##                                    0.002787374 
##                       ANESTHESIOLOGY ASSISTANT 
##                                    0.003011476 
##                              SURGICAL ONCOLOGY 
##                                    0.003088967 
##                                    AUDIOLOGIST 
##                                    0.003321303 
##                         GYNECOLOGICAL ONCOLOGY 
##                                    0.003338767 
##                      CLINICAL NURSE SPECIALIST 
##                                    0.003365498 
##                      SLEEP LABORATORY/MEDICINE 
##                                    0.003486039 
##             PLASTIC AND RECONSTRUCTIVE SURGERY 
##                                    0.003503535 
##                         CLINICAL SOCIAL WORKER 
##                                    0.003504867 
##                            PHYSICIAN ASSISTANT 
##                                    0.003727485 
##                        HOSPICE/PALLIATIVE CARE 
##                                    0.004339046 
##                                     HEMATOLOGY 
##                                    0.004687390 
##                                   CHIROPRACTIC 
##                                    0.004879876 
##             UNDEFINED PHYSICIAN TYPE (SPECIFY) 
##                                    0.005259370 
##                                PAIN MANAGEMENT 
##                                    0.005462010 
##                             ALLERGY/IMMUNOLOGY 
##                                    0.005519422 
##                          OBSTETRICS/GYNECOLOGY 
##                                    0.005558348 
##                 INTERVENTIONAL PAIN MANAGEMENT 
##                                    0.005914264 
##                               THORACIC SURGERY 
##                                    0.006537094 
##                                   NEUROSURGERY 
##                                    0.006735108 
##                               NUCLEAR MEDICINE 
##                                    0.007114638 
##                           OCCUPATIONAL THERAPY 
##                                    0.007266787 
##                                CARDIAC SURGERY 
##                                    0.007925134 
##                                   RHEUMATOLOGY 
##                                    0.007977905 
##                             RADIATION ONCOLOGY 
##                                    0.008299147 
##                          CLINICAL PSYCHOLOGIST 
##                                    0.008332354 
##                             GERIATRIC MEDICINE 
##                                    0.009220414 
##                               GENERAL PRACTICE 
##                                    0.009904835 
##                                      OPTOMETRY 
##                                    0.010093860 
##                               MEDICAL ONCOLOGY 
##                                    0.011625910 
##                                 OTOLARYNGOLOGY 
##                                    0.012735854 
##                                    DERMATOLOGY 
##                                    0.013412314 
##                                  ENDOCRINOLOGY 
##                                    0.013655352 
##                               PHYSICAL THERAPY 
##                                    0.013659409 
##                   CRITICAL CARE (INTENSIVISTS) 
##                                    0.013866190 
##                               VASCULAR SURGERY 
##                                    0.014547825 
##                      CARDIAC ELECTROPHYSIOLOGY 
##                                    0.014836384 
##         CERTIFIED REGISTERED NURSE ANESTHETIST 
##                                    0.015160854 
##                       INTERVENTIONAL RADIOLOGY 
##                                    0.015219609 
##                                     PSYCHIATRY 
##                                    0.016660387 
##                                        UROLOGY 
##                                    0.016789596 
##                      INTERVENTIONAL CARDIOLOGY 
##                                    0.017572522 
##                             ORTHOPEDIC SURGERY 
##                                    0.017578847 
##                                  OPHTHALMOLOGY 
##                                    0.017970523 
##                             EMERGENCY MEDICINE 
##                                    0.018279635 
##                                GENERAL SURGERY 
##                                    0.020289669 
##                                      NEUROLOGY 
##                                    0.020822856 
##                               GASTROENTEROLOGY 
##                                    0.021958394 
##                             INFECTIOUS DISEASE 
##                                    0.022069330 
##           PHYSICAL MEDICINE AND REHABILITATION 
##                                    0.022401198 
##                            HEMATOLOGY/ONCOLOGY 
##                                    0.022819822 
##                                 ANESTHESIOLOGY 
##                                    0.023894616 
##                                       PODIATRY 
##                                    0.025160524 
##                                     NEPHROLOGY 
##                                    0.028940651 
##                                      PATHOLOGY 
##                                    0.033222916 
##                              PULMONARY DISEASE 
##                                    0.035433680 
##                             NURSE PRACTITIONER 
##                                    0.036888685 
##                                FAMILY PRACTICE 
##                                    0.039854253 
##            CARDIOVASCULAR DISEASE (CARDIOLOGY) 
##                                    0.054053173 
##                              INTERNAL MEDICINE 
##                                    0.063283769 
##                           DIAGNOSTIC RADIOLOGY 
##                                    0.090427380