Consumers dissatisfied with primary care envision a more caring and coordinated system

Nov. 25, 2019

The Center for Consumer Engagement In Health Innovation (the Center) at Community Catalyst today released “In Their Words: Consumers’ Vision for a Person-Centered Primary Care System,” at a special event in the nation’s capital. Based on nine focus groups of low-income consumers with complex health and social needs, the report levels a pointed critique at an impersonal primary care system and suggests a practical, forward-thinking prescription for transforming that system.

“In Their Own Words” focus groups asked people directly about their experience with primary care and whether they would want that care to address non-medical aspects of their lives (e.g., housing, transportation, food security) that make a difference to their health and well-being – what are broadly known as social determinants of health.

“This report first and foremost underscores that our primary care system is not well organized around what consumers who are low-income say they need and want,” said Ann Hwang, MD, the director of the Center and a primary care provider herself. “The system, with hurried visits, large caseloads and high levels of paperwork, frustrates clinicians, as well, complicating the ability to deliver high quality, whole person care. The good news is that despite their cynicism and mistrust, consumers are very clear about what a better primary care system could and should look like. They remain hopeful, and their ideas are sweeping and could fundamentally restructure how primary care is delivered.”

“In Their Words” notes that many see “a healthcare system that is financially driven, leading to short and impersonal visits.” It is a system that consumers say is designed to “churn them through as quickly as possible and move on to the next person.”

Despite their disappointment in the system, focus group participants – who included low-income older adults, people from communities of color and others with complex health and social needs – were nevertheless able to articulate several key elements of a more person-centered primary care system.

•        Consumers want a long-term relationship with their primary care provider and they welcome broader, deeper conversations about both medical and social needs, undertaken with patience and empathy.

•        They expressed a desire for a navigator to help them make sense of and guide them through an imposing and confusing healthcare system.

•        They are enthusiastic about having a single place, where their primary care and social needs can be addressed under one roof.

•        They want providers who are culturally sensitive and can relate to their own life experiences and struggles, particularly around socio-economic and non-medical challenges.

The Center has the story.