The question of what do patients value is a very simple. They value a caring, educated, well-trained physician who gives them time to hear their concerns. Obviously, they care about more than that but that was a start. Other issues may include good parking, a nice and clean building, friendly staff and the ability to see their own doctor. Those are just basic business service principles and have been around for centuries or more. To me, these all fit in with Direct Primary Care. In the present model, time-constrained docs are burned out and lose their compassion. They have no time for their patients as they rush to see more and more of them. They have become RoboDocs who stare at a computer more than the patient. The staff are also overburdened and sometimes come off rude. When this happens, “broken windows” don’t get fixed and the little things slip in the office. There is a syringe cap on the floor, a dirty room never gets cleaned or there are no clean gowns to put on the patients.
Now, that is my opinion and my agenda (supporting DPC even though I don’t do it). What happens when you have another agenda? Well, you create a study trying to show that a PCMH (Patient Centered Medical Home) is what patients want. If you have ever read this blog then you would know that I hate made-up terms that do nothing. You cannot tell me the old family docs didn’t have a Patient Centered Medical Home. They would have laughed at the notion that it even needed a label. But back to my story. A recent study titled “Effects of Patient-Centered Medical Home Attributes on Patients’ Perceptions of Quality in Federally Supported Health Centers” just came out and the idiots at the AAFP were all over it. First of all, a “federally supported health center” is NOT representative of real life but I will let that slide. Here is what the found when interviewing about 5000 patients:
- 83.5 percent of patients reported excellent or very good overall quality of services,
- 81.3 percent reported excellent or very good quality of physician advice and treatment, and
- 84.3 percent said they were very likely to refer friends and relatives to the health care site.
Furthermore, PCMH attributes related to access to care and communication were associated with a greater likelihood of patients reporting high-quality care.
“These high patient ratings among health centers are especially remarkable given that low-income and uninsured patients across the United States generally rate their care much lower,” wrote the authors.
“Clinicians seeking to improve their patients’ overall perceptions of health care experiences should focus on improving patients’ experiences in getting access to care before and during the visit and on promoting clinician and support staff communication skills,” authors concluded.
Bottom line, what patients who participated in this study valued the most was access to and communication with their physicians and other health care professionals
So, here is my takeaway…….no shit! Yes, patients want to get in to see their doctors and want more time (communication) with their doctors. The present system, no matter what this study says, does not allow for it. Part of the problem type of research is that 95 percent of the interviews were conducted at health centers when patients were visiting for a health appointment. So, they in essence they were selected out as the ones who got access. What about all the other patients who couldn’t get in? Would they rate the PCMH so high?
The title of the linked AAFP article above is called Patients Value Physicians Access, Communication Offered in PCMH Model but that really isn’t the conclusion. That is the AAFP spin. Patients value the things I mentioned in my opening paragraph and that has NEVER changed and never will. Just because the AAFP wants you to believe the PCMH is the only way to do it doesn’t mean we should believe them. In fact, I still believe the opposite is true. The present healthcare model cannot deliver these values and it will only get worse no matter what pipe dreams come out of medical schools, the government, the medical residencies, the AAFP, the tooth fairy, MSNBC, etc.