Context: Osteonecrosis of the femoral head is a very challenging medical condition to treat. Since the condition is irreversible and often progressive, surgical management is a mainstay of therapy in symptomatic cases. In young patients, preservation of the femoral head for as long as possible is a goal, as endoprosthesis placement in this group will most likely require at least one revision within their lifetime. Objective. The purpose of this paper is to compare the results at one institution of free vascularized fibular grafting for the treatment of osteonecrosis between (1) physicians and (2) a control group of the population at large. A second purpose is to determine how compliant physicians are as patients when asked to follow another physician's instructions. Design. Physicians treated for stage II, III and IV avascular necrosis of the femoral head include a treatment period from 1986 to 1999. The control group consists of the entire population of patients treated with free vascularized fibular grafting from the onset of the senior author's experience, which ranges from 1979 to 1999. A total of 21 physicians (32 hips) were treated: 10 stage II, seven stage III and fifteen stage IV. The control group had a total of 1257 hips: 221 with stage II disease, 220 stage III and 816 stage IV. All patients were followed for a minimum of two years. Results. A total of twenty-one physicians (32 hips) were treated for avascular necrosis of the femoral head. The control group consists of 1257 hips. When compared with the senior author's entire experience treating stage II, III and IV avascular necrosis, the physician group displayed an excessively high degree of compliance during the immediate post-operative period (p>0.001). In addition the overall rate of recommended or conversion to total hip arthroplasty was significantly lower in the physician group (6.25%) compared to the control group (20.6%). Exercise, weight control and diet were all greatly stressed in our physician survey. Conclusion. The better outcome in physicians over the control group may be related to one or more factors including extensive non- and partial weight bearing, diet, weight control, and exercise.