Doc-Patient Relationship May Be Key to Quality
WEDNESDAY March 4, 2009 -- The level of personal connection between a patient and doctor affects the quality of care, U.S. researchers have found.
Because health care is often fragmented and uncoordinated, it's common for people to be cared for by different doctors. But the researchers found that people who have a strong relationship with a specific doctor are more likely to receive care that's consistent with recommended guidelines than are those who are connected to a medical practice but not to a particular physician.
The study included 155,590 adults in a primary care network. In addition to being less likely to receive recommended care, people who weren't connected to a specific doctor were less likely to complete recommended testing for prevention and care of chronic illness.
"This study provide strong evidence for the value of having a regular doctor," lead author Dr. Steven Atlas, director of primary care quality improvement at Massachusetts General Hospital, said in an American College of Physicians news release.
Atlas and his colleagues found that people connected to a physician were more likely to have health insurance, speak English and be non-Hispanic white. But they also found that connectedness was associated with larger disparities in screening rates than either race or ethnicity.
"The process of establishing a strong relationship with a specific physician may represent an important key to understanding disparities in care," Atlas said. "Greater insight into the role of patient-, provider- or practice-level barriers to establishing a closely connected primary care relationship may lead to improved quality of care for vulnerable patients."
The findings, published in the March 3 issue of Annals of Internal Medicine, could have health-care policy implications.
"Pay-for-performance initiatives hinge on the ability to accurately assign performance measures to those practitioners who have some control over the outcome," Atlas said. "Our study results suggest that physicians with a relatively low percentage of connected patients are likely to receive lower scores on performance measures when compared to physicians with a higher proportion of connected patients."
Posted: March 2009