Roberge D, Beaulieu M D, Haddad S, Lebeau R, Pineault R
Centre de recherche, Hôpital Charles LeMoyne, 3120, boulevard Taschereau, Greenfield Park, PQ, Canada.
Fam Pract. 2001 Feb;18(1):53-9. doi: 10.1093/fampra/18.1.53.
Changes in the organization of primary care practices are likely to have repercussions on the manner in which patients and physicians perceive loyalty to a regular source of care. A better understanding of their views will contribute to conceptual reflections on this poorly documented topic and, where needed, will reinforce efforts to adapt services to patient expectations.
The aims of this study are to document and compare the views that patients and GPs have of loyalty to the regular care provider.
This exploratory study uses the focus group technique. In 1997, we set up three groups of patients and three groups of physicians practising in Montreal. A total of 23 patients and 14 physicians participated in the study. The meetings investigated the participants' points of view on various aspects of the notion of loyalty. Analysis was based on transcripts of the meetings. The emerging themes were identified and the viewpoints were coded independently and then revised (when necessary) in order to obtain a consensus.
Patients and physicians have a relatively congruent vision of the notion of loyalty. This tendency to use the regular source of care over time appears to be rooted in a formal or informal contract between patients and their physicians and implies a sustained partnership and a strong interpersonal relationship. The relationship established is neither exclusive nor permanent. Patients periodically reconsider it by evaluating their physician's technical and interpersonal skills.
This study highlights the dynamic and multidimensional nature of the notion of loyalty. It shows that patients clearly identify with a particular physician rather than a clinic. The results challenge the prevailing methods of assessing longitudinality of care.
基层医疗实践组织的变化可能会对患者和医生对常规医疗服务来源的忠诚度的认知方式产生影响。更好地了解他们的观点将有助于对这个记录不完善的主题进行概念性思考，并在需要时加强根据患者期望调整服务的努力。
本研究的目的是记录并比较患者和全科医生对常规医疗服务提供者忠诚度的看法。
本探索性研究采用焦点小组技术。1997年，我们在蒙特利尔设立了三组患者和三组医生。共有23名患者和14名医生参与了研究。会议调查了参与者对忠诚度概念各个方面的观点。分析基于会议记录。确定了新出现的主题，并对观点进行了独立编码，然后（必要时）进行修订以达成共识。
患者和医生对忠诚度概念的看法相对一致。随着时间的推移，倾向于使用常规医疗服务来源似乎源于患者与其医生之间的正式或非正式契约，这意味着持续的伙伴关系和牢固的人际关系。建立的关系既不是排他性的也不是永久性的。患者会通过评估医生的技术和人际交往能力定期重新考虑这种关系。
本研究突出了忠诚度概念的动态性和多维度性。研究表明，患者明确认同的是特定医生而非诊所。研究结果对现行的评估医疗服务纵向性的方法提出了挑战。
