Understanding Rural Patients' Perspectives on Patient Care Teams

With a critical primary care clinician shortage, team-based care (TBC) is under development to enhance access, especially in rural regions. However, there has been limited discussion about TBC from the patient's perspective. We explored rural patient preferences for composition of their current and ideal primary health care team.

An anonymous online survey of rural residents was conducted within the Kootenay-Boundary region of British Columbia. The survey included demographic information and current and ideal health care team composition. Descriptive statistics were used.

Four hundred ninety individuals responded to the survey. Most respondents self-identified as female, were over age 40 years, White, and had a postsecondary school diploma. Those with a health care provider (n=362, 74%) included a primary care doctor (86.5%), alternative medicine practitioner (52.2%), allied health professional (35.4%), friends/family/support people (35.1%), specialist physician (30.1%) and nurse practitioner (18.5%) on their team. Ideal health care teams included a primary care physician (92.2%) followed by an alternative medicine practitioner (64.1%), allied health professionals (61.2%), specialist physician (59.8%), and nurse practitioner (54.8%). Almost half of all respondents (46.6%) chose five or more categories of team members and 43.7% chose 3-4 categories of members. Respondents (81.1%) were highly likely (49.6%) or likely (31.6%) to affiliate with a primary health care team clinic.

Both current and ideal health care team membership included many types of caregivers, with most respondents including three or more team-member categories. As many people in rural BC are without primary care providers, incorporating alternative medical practitioners and allied health professions into clinical teams within multidisciplinary settings could improve health care access.