The value of a family physician

Kurt C. Stange, Carlos R. Jaén, Sue Flocke, William L. Miller, Benjamin F. Crabtree, Stephen J. Zyzanski

Research output: Contribution to journalReview article

91 Citations (Scopus)

Abstract

Background. Most efforts to improve health care have been made without a full understanding of the value of a primary care approach. Methods. This article synthesizes the observations from the Direct Observation of Primary Care (DOPC) study. This multimethod study of 138 family physicians in 84 practices included direct observation of 4454 patient visits were used to describe aspects of family practice that may provide value for patients. Results. Family physicians provide and coordinate care for a wide variety of patient problems, prioritizing these competing demands on the basis of relationships developed during multiple patient visits over time. They use acute and chronic illness visits as opportunities to integrate care for specific diseases, mental health, and preventive care in ways that are tailored to the specific needs of patients and families. Higher rates of delivery of core attributes of family practice are associated with patient satisfaction and preventive services delivery, and are diminished by forced discontinuity of care. Conclusions. Family physicians prioritize and deliver care according to a broad agenda based on patient needs. These needs are understood within ongoing relationships with the patient, family, larger health care system, and community. This integrative approach includes numerous avenues for affecting important patient outcomes that are unlikely to be optimally met by less integrated models of medical care. Expanding the value of family practice will require the development and application of new knowledge of the core structures, processes, and contexts of family practice, and their effects on patient outcomes.

Original languageEnglish (US)
Pages (from-to)363-368
Number of pages6
JournalJournal of Family Practice
Volume46
Issue number5
StatePublished - May 1 1998
Externally publishedYes

Fingerprint

Family Physicians
Family Practice
Delivery of Health Care
Primary Health Care
Observation
Preventive Medicine
Family Health
Patient Satisfaction
Mental Health
Chronic Disease

Keywords

  • Family practice
  • Health care delivery
  • Physicians, family
  • Primary care

ASJC Scopus subject areas

  • Family Practice

Cite this

Stange, K. C., Jaén, C. R., Flocke, S., Miller, W. L., Crabtree, B. F., & Zyzanski, S. J. (1998). The value of a family physician. Journal of Family Practice, 46(5), 363-368.

The value of a family physician. / Stange, Kurt C.; Jaén, Carlos R.; Flocke, Sue; Miller, William L.; Crabtree, Benjamin F.; Zyzanski, Stephen J.

In: Journal of Family Practice, Vol. 46, No. 5, 01.05.1998, p. 363-368.

Research output: Contribution to journalReview article

Stange, KC, Jaén, CR, Flocke, S, Miller, WL, Crabtree, BF & Zyzanski, SJ 1998, 'The value of a family physician', Journal of Family Practice, vol. 46, no. 5, pp. 363-368.
Stange KC, Jaén CR, Flocke S, Miller WL, Crabtree BF, Zyzanski SJ. The value of a family physician. Journal of Family Practice. 1998 May 1;46(5):363-368.
Stange, Kurt C. ; Jaén, Carlos R. ; Flocke, Sue ; Miller, William L. ; Crabtree, Benjamin F. ; Zyzanski, Stephen J. / The value of a family physician. In: Journal of Family Practice. 1998 ; Vol. 46, No. 5. pp. 363-368.
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