Physician-patient connection boosts quality of care

Patients who don't have a specific primary physician have been found to be less likely to follow through with treatment plans.

By Brian Hedger — Posted March 19, 2009

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Patients who see a specific primary care physician receive better overall health care than those who are not connected to a doctor, according to a study in the March 3 Annals of Internal Medicine.

The report showed that patients who are not connected to a particular physician at a practice were less likely to receive recommended care, complete preventive tests or keep up with treatment for chronic illnesses.

"Our results imply that continuity of care counts, that a longstanding patient-physician relationship is all about knowledge and trust, and that it's good for the patient's well-being," said lead author Steven J. Atlas, MD, MPH, director of primary care quality improvement at Massachusetts General Hospital in Boston. "It underlines the value of primary care services, and having a [specific] physician as part of that team."

The study examined 155,590 adults who made at least one visit to one of 13 practices within Massachusetts General's primary care network from 2003 to 2005. Researchers tried to match patients with either a physician or a practice within the network. If they could not match patients to either, the patients were considered "unconnected" (link).

Connected patients were older, insured

Results showed that 59% of the patients were connected to a specific physician, 35% were connected only to a practice and 6% were unconnected. Those who were connected to a physician were more likely to speak English and be older, white, female and insured. Patients connected with a practice or deemed unconnected were more likely to be uninsured or covered by Medicaid.

"This strong relationship between patient-physician connectedness and race or ethnicity suggests that disparities in care may be mediated in part by the degree of connectedness to primary care physicians," the report found.

But Dr. Atlas emphasized that patient-physician connectedness is a two-way street. "It's not just the doctor or practice that determines how connected patients and doctors are. You can imagine that in a community health center, the patients have a lot more challenges. So they may be less connected with specific physicians in that practice and just come in for urgent care visits."

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