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Primary care highly valued, but difficulty accessing specialists undermines patient trust, UCSF study finds

In the first systematic study of what Americans value in primary health care, patients overwhelmingly endorsed the importance of primary care physicians, according to new research headed by the University of California, San Francisco. Almost all of the patients surveyed said they valued having a primary care physician who could coordinate their care and serve as a first point of contact.

Ratings of primary care physicians revealed high levels of patient trust, confidence, and satisfaction.

The study also found, however, that nearly a quarter of patients felt their primary care physician or medical group limited their access to specialists. Perceived barriers to specialty care led to dissatisfaction with primary care physicians and lower levels of trust. The study appears in the July 21 issue of the Journal of the American Medical Association (JAMA).

"Our study is an endorsement of primary care," said Kevin Grumbach, MD UCSF associate professor and chief of the Department of Family and Community Medicine at San Francisco General Hospital Medical Center. "Patients value primary care physicians, but don't want managed care plans forcing primary care physicians to be "gatekeepers" who ration their access to specialists." Grumbach is the principal investigator of the study.

In order to assess attitudes about the ease of receiving specialty care, the researchers targeted patients who were likely to need referrals. The 7,718 respondents had one of three age-related medical conditions - congestive heart failure, prostate disease, or stomach ulcers - and had a mean age of 67. They belonged to one of ten large medical groups in California.

The researchers were impressed at the very high rates of approval given to primary care physicians, said Grumbach. Ninety-four percent of patients valued having a primary care physician who knew their medical history and 89 percent valued the role of primary care physicians in coordinating referrals.

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Contact: Rebecca Sladek Nowlis or Lordelyn del Rosario
rsnowlis@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
21-Jul-1999


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