People want doctors to give more preventive care. A qualitative study of health care consumers.

BACKGROUND

We studied health care consumers' perspectives on provision of preventive care by physicians.

METHODS

In our qualitative study, we used the grounded theory method and a computerized text-base program (Nota Bene) to analyze 34 focus group interviews with 322 adults from a small Southern town and adjacent rural areas.

RESULTS

Based on our analysis of comments on prevention, we found seven reasons for going to the doctor: response to reminders, periodic examination, response to media messages, attempt to resolve conflicting information, concern about family pathology, attempt to allay anxiety, and illness. In addition, using respondents' comments, we developed a conceptual scheme of four levels of physicians' preventive care: (1) prevention needed, but physician offers no care; (2) physician merely recommends an intervention; (3) physician recommends and suggests ways to implement; and (4) physician recommends, gives implementation suggestions, and offers supportive follow-up. Physicians are more inclined to offer preventive care to patients who manifest pathology than to those who do not.

CONCLUSIONS

This conceptual scheme, reflecting patient perspectives, can help primary care physicians fit their styles of practice to different types of patients.