Skip to main content

Main menu

  • Home
  • Content
    • Current Issue
    • Online First
    • Multimedia
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • The Issue in Brief (Plain Language Summaries)
    • Call for Papers
  • Info for
    • Authors
    • Reviewers
    • Media
    • Job Seekers
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • RSS
    • Email Alerts
    • Journal Club
  • Contact
    • Feedback
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Content
    • Current Issue
    • Online First
    • Multimedia
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • The Issue in Brief (Plain Language Summaries)
    • Call for Papers
  • Info for
    • Authors
    • Reviewers
    • Media
    • Job Seekers
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • RSS
    • Email Alerts
    • Journal Club
  • Contact
    • Feedback
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Research ArticleOriginal Research

Adults’ Lack of a Usual Source of Care: A Matter of Preference?

Anthony J. Viera, Donald E. Pathman and Joanne M. Garrett
The Annals of Family Medicine July 2006, 4 (4) 359-365; DOI: https://doi.org/10.1370/afm.557
Anthony J. Viera
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Donald E. Pathman
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joanne M. Garrett
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • eLetters
  • PDF
Loading

Published eLetters

If you would like to comment on this article, click on Submit a Response to This article, below. We welcome your input.

Submit a Response to This Article
Compose eLetter

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

Vertical Tabs

Jump to comment:

  • Usual Source of Care Offers Convenience and Continuity
    Anthony J. Viera
    Published on: 28 August 2006
  • Usual source of care and interpersonal continuity
    John W. Saultz
    Published on: 15 August 2006
  • Published on: (28 August 2006)
    Page navigation anchor for Usual Source of Care Offers Convenience and Continuity
    Usual Source of Care Offers Convenience and Continuity
    • Anthony J. Viera, Chapel Hill, USA
    • Other Contributors:

    We thank Dr. Saultz for his letter and believe he has identified exactly the issue we find important from our study. Most people who do not have a usual source of care simply don’t want one or don’t want one enough to bother obtaining one. The most provocative policy question is whether having a usual source of care should be mandated in some fashion. As Dr. Saultz points out, without a publicly mandated program immunizati...

    Show More

    We thank Dr. Saultz for his letter and believe he has identified exactly the issue we find important from our study. Most people who do not have a usual source of care simply don’t want one or don’t want one enough to bother obtaining one. The most provocative policy question is whether having a usual source of care should be mandated in some fashion. As Dr. Saultz points out, without a publicly mandated program immunizations would never have become near-universal and thereby had their enormous impact on public health. Left to their preferences, many people would choose not to be immunized. But should a similar public health and paternalistic approach be taken to assure that every American has a medical home? Perhaps the answer depends on whether society views health care as largely a “consumer product” to be bought at the buyer’s discretion or something more.

    The fact that 3.3% of adults say they lack a usual source of care because they go to different places for different needs suggests that one place (or one health care provider) is just as good as another to many people.1 “Consumers” of health care often favor convenience over continuity. Part of the solution to medical homelessness, therefore, lies in improving the convenience of care provided by continuity physicians’ offices. We believe that a usual source of care can offer valuable continuity and convenience, but for having a usual source of care to become more universal, more people must learn of the value of continuity of care, and more doctors must recognize the barriers to continuity they create through the inconveniences their offices pose for patients. While there remain several challenges in improving America’s health, we believe educational interventions regarding the importance of having a usual source of care are a reasonable place to start.

    Anthony J. Viera, MD MPH, Donald E. Pathman, MD MPH, University of North Carolina, Department of Family Medicine

    1Viera AJ, Pathman DE, Garrett JM. Adults’ lack of a usual source of care: a matter of preference? Ann Fam Med 2006;4:359-65.

    Competing interests:   None declared

    Show Less
    Competing Interests: None declared.
  • Published on: (15 August 2006)
    Page navigation anchor for Usual source of care and interpersonal continuity
    Usual source of care and interpersonal continuity
    • John W. Saultz, Portland, Oregon

    I found the paper by Viera and colleagues to be an interesting addition to our literature about continuity of care. I doubt that many family physicians are surprised to learn that many, if not most, of those without a usual source of care choose not to have one. This finding correlates well with research that has shown that older and sicker people are more likely to have continuity with their primary provider. There a...

    Show More

    I found the paper by Viera and colleagues to be an interesting addition to our literature about continuity of care. I doubt that many family physicians are surprised to learn that many, if not most, of those without a usual source of care choose not to have one. This finding correlates well with research that has shown that older and sicker people are more likely to have continuity with their primary provider. There are also convincing data that certain desirable aspects of primary and preventive care occur more often in those with a usual source of care. What we don't know is whether giving a usual source of care to people who don't want one will improve their health or harm them.

    But imagine what an odd question this is! In America today, market driven health care is the ruling paradigm. Is our primary purpose to serve consumer demand or to care for patients' needs? How ofen are these the same thing and how often are they different? Surely people benefit from immunizations whether or not they want them? Is having a usual sopurce of care like this as well? Maybe we still have a lot to learn about what aspects of continuity of care really create measurable benefit for people before we try to desgn such a system for everyone? This study is a nice step in the direction of understanding this better.

    Competing interests:   None declared

    Show Less
    Competing Interests: None declared.
PreviousNext
Back to top

In this issue

The Annals of Family Medicine: 4 (4)
The Annals of Family Medicine: 4 (4)
Vol. 4, Issue 4
1 Jul 2006
  • Table of Contents
  • Index by author
  • In Brief
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Adults’ Lack of a Usual Source of Care: A Matter of Preference?
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
5 + 2 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Adults’ Lack of a Usual Source of Care: A Matter of Preference?
Anthony J. Viera, Donald E. Pathman, Joanne M. Garrett
The Annals of Family Medicine Jul 2006, 4 (4) 359-365; DOI: 10.1370/afm.557

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
Adults’ Lack of a Usual Source of Care: A Matter of Preference?
Anthony J. Viera, Donald E. Pathman, Joanne M. Garrett
The Annals of Family Medicine Jul 2006, 4 (4) 359-365; DOI: 10.1370/afm.557
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • INTRODUCTION
    • METHODS
    • RESULTS
    • DISCUSSION
    • Acknowledgments
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Implications of Reassigning Patients for the Medical Home: A Case Study
  • The Role of Usual Source of Care in Cholesterol Treatment
  • Comprehending Care in a Medical Home: A Usual Source of Care and Patient Perceptions about Healthcare Communication
  • In this Issue: Mixed Methods and Diverse Perspectives
  • Google Scholar

More in this TOC Section

  • Investigating Patient Experience, Satisfaction, and Trust in an Integrated Virtual Care (IVC) Model: A Cross-Sectional Survey
  • Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations
  • Evaluation of the Oral Health Knowledge Network’s Impact on Pediatric Clinicians and Patient Care
Show more ORIGINAL RESEARCH

Similar Articles

Subjects

  • Methods:
    • Quantitative methods
  • Other research types:
    • Health services
  • Core values of primary care:
    • Access
    • Continuity
  • Other topics:
    • Patient perspectives

Content

  • Current Issue
  • Past Issues
  • Past Issues in Brief
  • Multimedia
  • Articles by Type
  • Articles by Subject
  • Multimedia
  • Supplements
  • Online First
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Media
  • Job Seekers

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2023 Annals of Family Medicine