One Pagers | May 15, 2004
Mary Stock Keister, MD; Larry Green, MD; Norman Kahn, MD; Robert Phillips, MD, MSPH; Jessica McCann, MD; Ed Fryer, PhD
The public wants and is satisfied by care provided within a patient-physician relationship based on understanding, honesty and trust. If the U.S. healthcare system is ever to become patient-centered, it must be designed to support these values and sustain, rather than fracture, relationships people have with their primary physician.
Recognizing fundamental flaws in the U.S. healthcare system and the potential of an integrative, generalist approach to help remedy them, national family medicine organizations initiated the Future of Family Medicine Project (FFM) to develop a strategy to transform family medicine to better meet the needs of patients. As part of FFM, the global research company Roper ASW surveyed 1031 people between June 14 and July 1, 2002. The sample design mirrored the general population of the U.S. with regard to race, ethnicity, gender, age and location. Respondents were asked to grade the importance of 40 attributes "when it comes to your primary doctor." Overall, people want their primary doctor to meet the following five basic criteria: to be in their insurance plan, to be in a location that is convenient, to be able to schedule an appointment within a reasonable period of time, to have good communication skills, and to have a reasonable amount of experience in practice. Beyond the basic criteria, people value the relationship with their physician above all else, including service. People value a physician who listens to them, who takes the time to explain things to them and who is able to effectively integrate their care.1 The attributes identified as most important in driving patient satisfaction are rank ordered by their importance in the accompanying figure.
These national results are consistent with contemporary state studies examining patient preferences and satisfaction.2,3 Also, the physician attributes influencing patient satisfaction fit neatly within the definition of primary care published by the Institute of Medicine in 1996 and correlate with drivers of family physician satisfaction.4 Both the public and family physicians want primary care within a continuous patient-physician relationship grounded on understanding, honesty and trust. The current healthcare system fractures these relationships leaving patients and family physicians dissatisfied. Whatever course is pursued in the development of an equitable, accessible system for all Americans, it must recognize that people want the type of care that family physicians want to provide.
The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP.
Published in American Family Physician, May15, 2004. Am Fam Physician. 2004;69(10):2310. This series is coordinated by Sumi Sexton, MD, AFP Associate Medical Editor.