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Who is the primary physician?

J S Spiegel, L V Rubenstein, B Scott

The New England Journal of Medicine

|May 19, 1983

Summary

This summary is machine-generated.

Defining primary care physicians requires more than just identifying who provides the majority of care. Patient perception and specific primary care tasks are crucial for accurate identification, especially concerning specialists.

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Area of Science:

Health Services Research
Primary Care Medicine
Medical Economics

Background:

Previous research suggested specialists form a significant part of primary care delivery.
These studies often defined primary care physicians by the majority of care provided.

Purpose of the Study:

To examine the validity of using the "majority of care" criterion to identify primary care physicians.
To compare different definitions of primary care physicians and their impact on identifying specialists' roles.

Main Methods:

Analysis of one-year data from 2752 individuals in the Rand Health Insurance Experiment.
Comparison of three primary care physician definitions: "majority of care," patient designation for screening results, and provider of common problems.

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Main Results:

The "majority of care" definition overestimated specialists' primary care contribution threefold.
Patient designation identified 12% specialists; common problem treatment identified 9% specialists.

Conclusions:

The "majority of care" definition is an unreliable metric for primary care physician identification.
Accurate definitions must incorporate specific primary care tasks and patient perceptions.