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Research ArticleOriginal Research

Exploring the Patient and Staff Experience With the Process of Primary Care

Elizabeth J. Brown, Shreya Kangovi, Christopher Sha, Sarah Johnson, Casey Chanton, Tamala Carter and David T. Grande
The Annals of Family Medicine July 2015, 13 (4) 347-353; DOI: https://doi.org/10.1370/afm.1808
Elizabeth J. Brown
1The Robert Wood Johnson Foundation Clinical Scholars Program, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
2The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
3The Department of Family and Community Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
MD, MSHP
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  • For correspondence: elizbro@upenn.edu
Shreya Kangovi
2The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
4The Division of General Internal Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
5Penn Center for Community Health Workers, Philadelphia, Pennsylvania
MD, MSHP
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Christopher Sha
6Department of Medicine, University of San Francisco, San Francisco, California
MD
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Sarah Johnson
7Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, Maryland
MD
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Casey Chanton
5Penn Center for Community Health Workers, Philadelphia, Pennsylvania
MSW
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Tamala Carter
5Penn Center for Community Health Workers, Philadelphia, Pennsylvania
CHW
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David T. Grande
1The Robert Wood Johnson Foundation Clinical Scholars Program, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
2The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
4The Division of General Internal Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
MD, MPA
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  • Work for FMAHealth
    Jeffrey Borkan
    Published on: 28 July 2015
  • Author response: thanks
    Jean Antonucci
    Published on: 27 July 2015
  • Published on: (28 July 2015)
    Page navigation anchor for Work for FMAHealth
    Work for FMAHealth
    • Jeffrey Borkan, Physician - Anthropologist

    The authors, in this well-written and thought provoking article, underscore many of the limitations of our current primary care delivery system. The FMAHealth (Family Medicine for America's Health) initiative may need to address these "internal issues" if we want to fulfill the potential for primary care.

    Competing interests: None declared

    Competing Interests: None declared.
  • Published on: (27 July 2015)
    Page navigation anchor for Author response: thanks
    Author response: thanks
    • Jean Antonucci, physician

    Thanks for writing and documenting what many of us think about and have noticed for years. Well done. When I was a resident it was clear that continuity with physician did not exist but what worked for patients was continuity with a place, its staff and a system. But if we drew a spaghetti diagram as patients progress though a medical visit and color coded it, the line representing patient agenda and needs would bec...

    Show More

    Thanks for writing and documenting what many of us think about and have noticed for years. Well done. When I was a resident it was clear that continuity with physician did not exist but what worked for patients was continuity with a place, its staff and a system. But if we drew a spaghetti diagram as patients progress though a medical visit and color coded it, the line representing patient agenda and needs would become fainter and fainter as staff try to check boxes and get "reimbursed." The only good results often come, as Milstein wrote years ago about Health Care Home Runs, on the backs of the personnel who work beyond and around the absurd US system.

    Competing interests: None declared

    Show Less
    Competing Interests: None declared.
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The Annals of Family Medicine: 13 (4)
The Annals of Family Medicine: 13 (4)
Vol. 13, Issue 4
July/August 2015
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Exploring the Patient and Staff Experience With the Process of Primary Care
Elizabeth J. Brown, Shreya Kangovi, Christopher Sha, Sarah Johnson, Casey Chanton, Tamala Carter, David T. Grande
The Annals of Family Medicine Jul 2015, 13 (4) 347-353; DOI: 10.1370/afm.1808

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Exploring the Patient and Staff Experience With the Process of Primary Care
Elizabeth J. Brown, Shreya Kangovi, Christopher Sha, Sarah Johnson, Casey Chanton, Tamala Carter, David T. Grande
The Annals of Family Medicine Jul 2015, 13 (4) 347-353; DOI: 10.1370/afm.1808
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Subjects

  • Person groups:
    • Vulnerable populations
  • Methods:
    • Qualitative methods
  • Other research types:
    • Health services
  • Core values of primary care:
    • Access
    • Coordination / integration of care

Keywords

  • patients
  • medical staff
  • patient-centered medical home
  • primary care
  • practice-based research
  • process of care
  • office visits
  • chronic illness
  • vulnerable populations
  • qualitative research

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