News Release

Organization of health care facility linked to successful patient-physician relationship

Peer-Reviewed Publication

Center for Advancing Health

Embargoed for Release: The quality of a low-income woman’s relationship with her primary care physician is profoundly affected by the way her health care site is organized, according a study published in the January issue of the Journal of General Internal Medicine.

Study findings indicate that a facility is more likely to make a lower-income woman feel that her care provider is compassionate and that she can trust in and communicate well with that physician if it: emphasizes a continuing relationship with a single primary care physician; enables that physician to offer comprehensive care; does a better job of coordinating care with specialists; and provides easier access to staff members.

Of these attributes, two – comprehensive care and access to staff members – are also associated with higher ratings of physician compassion.

The quality of primary care experiences are critical, notes lead author Ann O’Malley, M.D., M.P.H., of the Georgetown University Medical Center, because primary care is a patient’s first point of contact with the health care system. For lower-income and minority women, O’Malley says, “a strong patient-physician relationship is crucial to obtaining needed health services.”

O’Malley cites previous research, indicating that patients who sense they can trust and communicate well with their primary care provider, feel that they are treated humanely and have a sustained relationship with a single provider are not only more satisfied with their care, but also more likely to adhere to recommended behavior changes. In addition, she notes, “Dissatisfaction with the patient-physician relationship is a leading predictor of health plan disenrollment,” a problem that is especially common among women and nonwhite patients.

To determine which features of primary care systems foster the most satisfactory relationships between low-income women and their physicians, O’Malley and her colleague, Christopher B. Forrest, M.D., Ph.D., conducted a telephone survey of women over the age of 40 and living in low-income census tracts in Washington, D.C. All interviewers spoke both English and Spanish. A total of 1,205 women, 82 percent of them African American, completed the survey.

The most striking study finding is that women who rate their primary physician’s care as more comprehensive – that is, who report that their provider meets or can arrange for all of their health care needs – are 11 times more likely to trust the physician and six times more likely to rate the physician as compassionate and communicative.

According to O’Malley, these results indicate that certain “features outside of the examination room played a role in how women interacted with their doctors” and suggest that attention to these features could help primary care facilities serving lower-income women improve both patient satisfaction and patient care.

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Support for the research was provided by the U.S. Department of Army and the National Cancer Institute.

The Journal of General Internal Medicine, a monthly peer-reviewed journal of the Society of General Internal Medicine, publishes original articles on research and education in primary care. For information about the journal, contact Renee F. Wilson at (410) 955-9868.

Posted by the Center for the Advancement of Health (http://www.cfah.org). For more research news and information, go to our special section devoted to health and behavior in the “Peer-Reviewed Journals” area of Eurekalert!, http://www.eurekalert.org/jrnls/cfah/. For information about the Center, call Ira Allen, iallen@cfah.org, (202) 387-2829.


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