Physician Practice Styles and Patient Outcomes

Differences Between Family Practice and General Internal Medicine

Bibliographic Data

ID9101742
AuthorsKlea D Bertakis (corresponding author), Edward J Callahan (0000-0002-2399-3557, Centre for Family Medicine, corresponding author), L Jay Helms (University of California, Davis), Razieh Azari (0000-0002-4844-639X, University of California, Davis), Rahman Azari, John A Robbins (0000-0002-8937-9613, University of California, Davis), Jill Miller
Year1998
Volume36
Issue6
Pages879-891
Publication date1998-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199806000-00011
PMID9630129
OpenAlexW1987451819
LanguageEN
Citations received15
References cited12

OBJECTIVES: This study compared patient health status, patient satisfaction, and physician practice style between family practice and internal medicine. METHODS: New adult patients (n = 509) were prospectively and randomly assigned to family practice or internal medicine clinics at a university medical center and followed for 1 year of care. Practice styles were characterized by the Davis Observation Code. Self-reported health status (Medical Outcomes Study, Short Form-36) and patient satisfaction also were measured. RESULTS: There were no significantly different changes in self-reported health status or patient satisfaction between family practice and internal medicine physicians during the course of the study. Family practice initial encounters, however, were characterized by a style placing greater relative emphasis on health behavior and counseling, whereas internists used a more technical style. Improved health status scores after treatment were predicted by a practice style emphasis on counseling, whereas improvements in patient satisfaction scores were predicted by a style of care stressing patient activation. Although this is the first known randomized trial studying this issue, the conclusions are limited by a 38% loss of patients from enrollment to care and a loss of 18% at the 1-year follow-up evaluation. CONCLUSIONS: There were significant differences in practice styles between family physicians and internists; however, it was the physician's behavior, not specialty per se, that affected patient outcomes. A practice style emphasizing psychosocial aspects of care was predictive of improvements in patient health status, whereas a practice style emphasizing patient activation was predictive of improvements in patient satisfaction

Family medicine · Health care · Medical practice · MEDLINE · Patient satisfaction · Psychiatry · Psychosocial · Specialty · Healthcare professionals’ stress and burnout · Medicine · Nursing · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes

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