Health demand in primary care context: what do people think about physicians?

This research aims to explore the link between health demand and representation of medical function in a sample of 86 individuals (aged between 18 and 74) from Italy. A questionnaire has been administered for the analysis of cultural models (Carli & Paniccia 1999) in terms of affective symbolisations characterising physician-patient relationship. The questionnaire has been constructed according to a socio-constructivist methodology and allows to explore two specific emotional areas: (1) The view about medical profession and health care setting in general, (2) the experience referred to one's own general practitioner. Five clusters of subjects have been identified, thanks to multivariate statistic techniques (multiple correspondence analysis (MCA) and cluster analysis (CA). They show respectively: A deep concern for health and a paternalistic dynamics with physician (20.9% of the sample); a general distrust of the health service and a fatalistic view about health leading to avoid the use of visits (16.3%); a passive and dependent position in relation to physician seen as a skilled and powerful technician (20.9%); a little compliance with physician considered as a bureaucrat that must satisfy any request (20.9%); an active role in health management and a greater confidence in medical function for a better quality of life (20.9%). Results point out some differences by age, education and occupation. In particular, participants with university schooling (p < 0. 01) and professionals (p < 0. 05) show less motivation to use primary care services, while participants aged from 45 to 74 years (p < 0.05) and with elementary-middle schooling (p < 0.05) are more confident in medical function for health promotion. Findings suggest some indications on health demand and provide development lines for improving communication in primary care context.