Introducing family medicine in a pluralistic health care system: how patients and doctors see it

Fam Pract. 2011 Feb;28(1):49-55. doi: 10.1093/fampra/cmq064. Epub 2010 Aug 9.

Abstract

Background: The health care systems in many countries are focused on specialist care. In those countries that have recently changed to a primary care-based system, some doctors and patients were dissatisfied with the change.

Objective: To explore the opinions of the general public and the doctors on the change to a family medicine (FM)-based health care system.

Methods: Qualitative study with focus groups of doctors working in different practice settings. Quantitative study with questionnaires sent to all doctors registered in Hong Kong and a telephone survey targeting the general public aged ≥18.

Results: Doctors in the focus groups generally supported a FM-based health care system. They were concerned that there were not enough family doctors for such a system and the patients' current free choice of any doctor for primary care would impede its success. Thousand six hundred and forty-seven adults took part in the telephone survey (response rate 67.6%) and 2310 doctors (22.8%) responded to the questionnaire. Nearly 95% of the general public respondents agreed to the FM system though only 66.3% of them had ever heard of the term family doctor. About 65% of the doctors supported this system but only 33% agreed that the system would work. The specialist-doctors were less supportive of mandatory referral than the non-specialists, while the public was equally divided on this issue.

Conclusions: The public accepts the FM-based system but needs education on the benefits of primary health care. Direct access to the specialist would be the greatest barrier. Government involvements are essential for the reform.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Attitude to Health*
  • Delivery of Health Care / methods*
  • Family Practice / methods*
  • Female
  • Focus Groups
  • Health Care Reform / methods*
  • Health Policy / trends
  • Hong Kong
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Primary Health Care / methods*
  • Qualitative Research
  • Specialization / trends
  • Young Adult