The value of a family physician

Kurt C. Stange, Carlos R. Jaén, Susan A. Flocke, William L. Miller, Benjamin F. Crabtree, Stephen J. Zyzanski

Research output: Contribution to journalReview articlepeer-review

102 Scopus citations


Background. Most efforts to improve health care have been made without a full understanding of the value of a primary care approach. Methods. This article synthesizes the observations from the Direct Observation of Primary Care (DOPC) study. This multimethod study of 138 family physicians in 84 practices included direct observation of 4454 patient visits were used to describe aspects of family practice that may provide value for patients. Results. Family physicians provide and coordinate care for a wide variety of patient problems, prioritizing these competing demands on the basis of relationships developed during multiple patient visits over time. They use acute and chronic illness visits as opportunities to integrate care for specific diseases, mental health, and preventive care in ways that are tailored to the specific needs of patients and families. Higher rates of delivery of core attributes of family practice are associated with patient satisfaction and preventive services delivery, and are diminished by forced discontinuity of care. Conclusions. Family physicians prioritize and deliver care according to a broad agenda based on patient needs. These needs are understood within ongoing relationships with the patient, family, larger health care system, and community. This integrative approach includes numerous avenues for affecting important patient outcomes that are unlikely to be optimally met by less integrated models of medical care. Expanding the value of family practice will require the development and application of new knowledge of the core structures, processes, and contexts of family practice, and their effects on patient outcomes.

Original languageEnglish (US)
Pages (from-to)363-368
Number of pages6
JournalJournal of Family Practice
Issue number5
StatePublished - May 1998
Externally publishedYes


  • Family practice
  • Health care delivery
  • Physicians, family
  • Primary care

ASJC Scopus subject areas

  • Family Practice


Dive into the research topics of 'The value of a family physician'. Together they form a unique fingerprint.

Cite this