[Users-physicians: in search of new ways of detecting problems of quality]

1) To develop experimentally a method of detecting quality problems in primary care, based on the patient's analysis of his/her overall health-care experience. 2) To perceive and assimilate, from the point of view of the providers, aspects of care related to patients' expectations.

A descriptive concurrent study in which "user-doctors" visit their general practitioners as patients.

Health centres, located in Aragón and Rioja.

Thirty-two doctors doing a doctorate.

Filling-out of a semi-structured questionnaire and individual elaboration of a report analysing the different care stages: appointment, waiting, visit and referrals. Main variables of the study: accessibility, waiting time, comfort, doctor's interest, quality of information, satisfaction, treatment received. For each stage, in line with prior expectations, the detection of problems, the search for positive aspects and the analysis of the care situation with corrective measures were proposed.

Problems detected: difficulty of telephone contact, uncomfortable and lengthy wait, health staff smoking, scant interest from the doctor, no greeting on entry, interruptions during the visit, insufficient information. Positive aspects: facilities in choice of appointment, cordiality of treatment, personal call by the doctor, punctuality.

The method is simple, economical, sensitive in detecting problems felt by the users, and feasible as a complement to other systems used in our ambit.