Cherkin D C, Hart L G, Rosenblatt R A
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98121.
J Fam Pract. 1988 May;26(5):543-51.
Although general internists and family physicians see similar types of patients, they have been found to have different styles of practice. It is not known whether these differences in practice style are associated with differences in outcomes of care such as patient satisfaction. This study examined whether patients of family physicians and general internists have different perceptions of the care they receive. National samples of recently trained family physicians and general internists were asked to complete questionnaires about their practices and to record information on all patient encounters during a three-day period. Three patients were randomly sampled from among those seen by each physician during the study period and were sent questionnaires that included questions about their satisfaction with the medical care they were receiving from the physician. Two hundred thirteen adult patients who saw 124 family physicians and 218 adult patients who saw 98 general internists participated in this study. Patients of general internists and of family physicians reported similar levels of satisfaction on all four dimensions measured (access, humaneness, quality, and general satisfaction) even after controlling for the effects of a variety of patient, practice, physician, and encounter characteristics. It is concluded that the fundamental differences in practice style that have been reported between family physicians and general internists do not seem to be associated with differences in patient satisfaction.
尽管普通内科医生和家庭医生诊治的患者类型相似，但人们发现他们的行医风格有所不同。目前尚不清楚这些行医风格的差异是否与诸如患者满意度等护理结果的差异相关。本研究调查了家庭医生和普通内科医生的患者对他们所接受护理的看法是否存在差异。研究要求近期接受培训的家庭医生和普通内科医生的全国样本填写有关其行医情况的问卷，并记录为期三天内所有患者诊疗的信息。从每位医生在研究期间诊治的患者中随机抽取三名患者，并向他们发送问卷，其中包括有关他们对从该医生处接受的医疗护理满意度的问题。124名家庭医生诊治的213名成年患者和98名普通内科医生诊治的218名成年患者参与了本研究。即使在控制了各种患者、行医、医生和诊疗特征的影响之后，普通内科医生和家庭医生的患者在所有四个测量维度（可及性、人道性、质量和总体满意度）上报告的满意度水平相似。研究得出结论，家庭医生和普通内科医生之间报告的行医风格的根本差异似乎与患者满意度的差异无关。
