Choosing a Primary Care Provider: A Formative Qualitative Study to Identify Patient Preferences

(1) Identify what characteristics patients evaluate when choosing their primary care provider (PCP), (2) characterize how provider characteristics factor into patients' choice of PCP, and (3) develop a list of features for a quantitative preference study in the form of a discrete choice experiment (DCE).

We used a cross-sectional, qualitative study to accomplish the objectives. We recruited participants from an internal medicine clinic and the general public in North Carolina. We used convenience and purposive sampling to recruit participants as a single sample. All participants completed a semi-structured interview. We then used a reflexive thematic analysis to analyze the data. We conducted a focus group to confirm and refine the interview findings. Finally, we created and prioritized a list of attributes and attribute levels for use in a future DCE study.

We conducted 12 interviews to reach data saturation. Participants mostly identified as female (75%, n=9), white (67%, n=8), and non-Hispanic/Latino (83%, n=10), with a mean age of 39 years (SD=15). Participants reported examining factors across several domains when deciding on their PCP: (1) knowledge/experience/age, (2) gender alignment, (3) convenience, and (4) cost. Based on the results of the interviews, we selected five preference-sensitive attributes and confirmed these with the focus group. Attributes that will be included in a future study include provider profession, provider race and gender, an attribute describing what the provider is known for, appointment availability, and driving time.

We found that participants reported evaluating several important factors when deciding on selecting a PCP. Elucidating patients' willingness to accept different types of PCPs has policy implications for provider integration, cost-savings, and workload optimization.