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How Experiencing Preventable Medical Problems Changed Patients’ Interactions With Primary Health Care

¹ Department of Family Medicine, University of Cincinnati, Cincinnati, Ohio
² Department of Research, Olmstead Medical Center, Rochester, Minn
³ Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

CORRESPONDING AUTHOR: Nancy C. Elder, MD, MSPH, Department of Family Medicine, University of Cincinnati, PO Box 670582, Cincinnati, OH 45267-0582, Eldernc{at}fammed.uc.edu

PURPOSE We wanted to explore how patients’ experiences with preventable problems in primary care have changed their behavioral interactions with the health care system.

METHODS We conducted semistructured interviews with 24 primary care patients, asking them to describe their experiences with self-perceived preventable problems. We analyzed these interviews using the editing method and classified emotional and behavioral responses to experiencing preventable problems.

RESULTS Anger was the most common emotional response, followed by mistrust and resignation. We classified participants’ behavioral responses into 4 categories: avoidance (eg, stop going to the doctor), accommodation (eg, learn to deal with delays), anticipation (eg, attend to details, attend to own emotions, acquire knowledge, actively communicate), and advocacy (eg, get a second opinion).

CONCLUSIONS Understanding how patients react to their experiences with preventable problems can assist health care at both the physician-patient and system levels. We propose an association of mistrust with the behaviors of avoidance and advocacy, and suggest that further research explore the potential impact these patient behaviors have on the provision of health care.

Key Words: Primary health care • professional-patient relations • patient safety • patients

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