Patient preference in primary care provider type

Given the growing roles of nurse practitioners (NPs) and physician assistants (PAs), patients are increasingly able to choose their primary care provider type. Studies examining patient preferences among provider types are limited and ours is the first to examine reasons for patients' provider type preferences.

Using data from the 2014 Association of American Medical Colleges' (AAMC) Consumer Survey of Health Care Access, we used qualitative analysis to identify themes in open text responses of reasons for respondents' provider type preference (N = 4220). After coding responses for themes, we used chi-square tests to assess whether there were statistically significant differences in respondents' reasons for their provider preference, and whether reasons vary by the gender, race, or age of the respondent.

Those preferring physicians were more likely to cite physician qualifications (75%) and trust (7%) than those preferring NP/PAs (qualifications = 36%; trust = 4%). Those preferring NP/PAs were more likely to cite bedside manner (20%) and convenience (9%) than those preferring physicians (bedside manner = 5%; convenience = 4%). Both groups of respondents were equally likely to mention previous experience with their provider type as a reason for their preference (prefer physician = 19%; prefer NP/PA = 21%).

Provider qualifications and previous health care experiences are cited as key reasons for preferring all provider types. Additionally, physicians are more often preferred for their qualifications and technical skills, whereas NP/PAs are more often preferred for their interpersonal skills.

Our results could help providers, health system administrators, workforce planners, and policy makers better understand patient perspectives and design care that enhances patient satisfaction.