Loosening the gatekeeping restrictions of managed care health plans or promoting access to care and continuity of treatment may improve the relationship between patients and their physicians, according to researchers at the Johns Hopkins Bloomberg School of Public Health.

Restrictions that require patients to select a primary care physician or obtain authorization for specialty care referrals were associated with a low patient-practitioner relationship rating in a study published in the April 2002 issue of the Journal of General Internal Medicine. The findings provide new information on the ways in which managed care influences patients relationships with their primary care practitioners and may lead to the development of more patient-centered health care programs.

Across the United States, managed health plans are loosening restrictions on patients access to specialist care. According to this study, this trend may lead to better patient relationships with their primary care practitioners, says the studys lead author Christopher Forrest, MD, PhD, associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.

For the study, the Dr. Forrest and his colleagues examined the patient-practitioner relationship, which is characterized by physician empathy towards their patients, communication between doctor and patient, and mutual trust.

Data were collected from the 1996-1997 Community Tracking Study Household Survey, which was a survey designed to monitor the effects of health system changes on people living in the United States.

The survey asked patients to rate the level of trust they had in their doctor and his or her ability to make decisions in the patients best interest. Patients rated the level of communication with their doctor and the doctors competence during examination and treatment. Access to primary care was assessed by asking patients the time it took to travel to a doctors appo
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Contact: Tim Parsons or Ming Tai
paffairs@jhsph.edu
410-955-6878
Johns Hopkins University Bloomberg School of Public Health
15-Apr-2002