Exploring the patient and staff experience with the process of primary care

Elizabeth J. Brown, Shreya Kangovi, Christopher Sha, Sarah Johnson, Casey Chanton, Tamala Carter, David T. Grande

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


PURPOSE Previous studies suggest that the highest-risk patients value accessible, coordinated primary care that they perceive to be of high technical quality. We have limited understanding, however, of how low-income, chronically ill patients and the staff who care for them experience each individual step in the primary care process. METHODS We conducted qualitative interviews with uninsured or Medicaid patients with chronic illnesses, as well as with primary care staff. We interviewed 21 patients and 30 staff members with a variety of job titles from 3 primary care practices (1 federally qualified health center and 2 academically affiliated clinics). RESULTS The interviews revealed 3 major issues that were present at all stages of a primary care episode: (1) information flow throughout an episode of care is a frequent challenge, despite systems that are intended to improve communication; (2) misaligned goals and expectations among patients, clinicians, and staff members are often an impediment to providing and obtaining care; and (3) personal relationships are highly valued by both patients and staff. CONCLUSIONS Vulnerable populations and the primary care staff who work with them perceive some of the same challenges throughout the primary care process. Improving information flow, aligning goals and expectations, and developing personal relationships may improve the experience of both patients and staff.

Original languageEnglish (US)
Pages (from-to)347-353
Number of pages7
JournalAnnals of family medicine
Issue number4
StatePublished - Jan 1 2015


  • Chronic illness
  • Medical staff
  • Office visits
  • Patient-centered medical home
  • Patients
  • Practice-based research
  • Primary care
  • Process of care
  • Qualitative research
  • Vulnerable populations

ASJC Scopus subject areas

  • Family Practice


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