Two physician styles of focusing on the family - Their relation to patientoutcomes and process of care

BACKGROUND Previous research has identified 2 styles of family physicians' focus on the patient's family: (1) using the family history as the context of care of the patient; and (2) maintaining a family orientation with the f amily as the unit of care. The purpose of our study was to determine whethe r these styles affect patient outcomes and time use during outpatient visit s. METHODS In a cross-sectional study, data on 4454 outpatient visits to 138 c ommunity family physicians were collected using direct observation, patient and physician questionnaires, and medical record review. We computed parti al correlations between the physician's family practice style score and pat ient outcomes for delivery of preventive services, patient visit satisfacti on, and patient-reported delivery of specific components of primary care. W e controlled for relevant patient characteristics. RESULTS The patients of the physicians using either practice style had simi lar levels of satisfaction with coordination of care and interpersonal comm unication, and their value of continuity of care was comparable. Patients o f physicians with a family-history style, however, rated their physicians l ower on a measure of in-depth knowledge of the patient and family but highe r on preventive services delivery, Differences in time use during the visit reflected how these styles were manifested during the outpatient visit. CONCLUSIONS The different styles physicians use to focus on the family affe ct the process and outcomes of patient care, This difference may be explain ed by the developmental life cycle of family physicians, as younger physici ans may be more focused on family history and older physicians may have a m ore family-oriented focus, Physicians may need to find alternate ways of me eting those patient needs not well met by their predominant practice style.