Journal of General Internal Medicine

, Volume 15, Issue 2, pp 75–83

Patient preferences for care by general internists and specialists in the ambulatory setting

  • Carmen L. Lewis
  • Glenda C. Wickstrom
  • Maria M. Kolar
  • Thomas C. Keyserling
  • Bryan A. Bognar
  • Connie T. DuPre
  • Juliana Hayden
Original Articles

DOI: 10.1046/j.1525-1497.2000.05089.x

Cite this article as:
Lewis, C.L., Wickstrom, G.C., Kolar, M.M. et al. J GEN INTERN MED (2000) 15: 75. doi:10.1046/j.1525-1497.2000.05089.x

Abstract

OBJECTIVE: To investigate patients’ preferences for care by general internists and specialists for common medical conditions.

DESIGN: Telephone interview.

SETTING: A convenience sample of general internal medicine practices at 10 eastern academic medical centers.

PATIENT/PARTICIPANTS: A probability sample of 314 participants who had at least one visit with their primary care physician during the preceding 2 years.

MEASUREMENTS AND MAIN RESULTS: Items addressed patients’ attitudes concerning continuity of care, preferences for care by general internists or specialists for common medical problems, and perceptions about the competency of general internists and specialists to manage these problems. Continuity was important to participants, with 63% reporting they preferred having one doctor. Respondents were willing to wait 3 or 4 days to see their regular doctor (85%) and wanted their doctor to see them in the emergency department (77%) and monitor their care while in the hospital (94%). A majority (>60%) preferred care from their regular doctor for a variety of new conditions. Though respondents valued continuity, 84% felt it was important to be able to seek medical care from any type of physician without a referral, and 74% responded that if they needed to see a specialist, they were willing to pay out-of-pocket to do so. Although most participants (98%) thought their regular doctor was able to take care of usual medical problems, the majority through that specialists were better able to care for allergies (79%) and better able to prescribe medications for depression (65%) and low-back pain (72%).

CONCLUSIONS: Participants preferred to see their general internist despite their perceptions that specialists were more competent in caring for the conditions we examined. However, they wanted unrestricted access to specialists to supplement care provided by general internists.

Key words

decision making patient participation referral and consultation 

Copyright information

© Society of General Internal Medicine 2000

Authors and Affiliations

  • Carmen L. Lewis
    • 1
  • Glenda C. Wickstrom
    • 2
  • Maria M. Kolar
    • 3
  • Thomas C. Keyserling
    • 1
  • Bryan A. Bognar
    • 4
  • Connie T. DuPre
    • 5
  • Juliana Hayden
    • 6
  1. 1.the Department of MedicineUniversity of North Carolina at Chapel Hill School of MedicineChapel Hill
  2. 2.Department of MedicineSumma Health System/Northeastern Ohio Universities College of MedicineAkron
  3. 3.Section of Internal MedicineWest Virginia University School of MedicineMorgantown
  4. 4.Department of Internal MedicineUniversity of South Florida School of MedicineTampa
  5. 5.Section of General MedicineMedical College of GeorgiaAugusta
  6. 6.Department of Internal MedicineUniversity of Louisville School of MedicineLouisville
  7. 7.CB#7110 The University of North Carolina at Chapel HillChapel Hill