Characteristics of general practice care: what do senior citizens value? A qualitative study.

BACKGROUND: In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is to improve our understanding about preferences of this group of patients in relation to non-medical attributes of primary health care. This may help to develop strategies to improve the quality of care that senior citizens receive from their GP. METHODS: Semi-structured interviews (N = 13) with senior citizens (65-91 years) in a judgement sample were recorded and transcribed verbatim. The analysis was conducted according to qualitative research methodology and the frame work method. RESULTS: Continuity of care providers, i.e. GP and practice nurses, GPs' expertise, trust, free choice of GP and a kind open attitude were highly valued. Accessibility by phone did not meet the expectations of the interviewees. The interviewees had difficulties with the GP out-of-office hours services. Spontaneous home visits were appreciated by some, but rejected by others. They preferred to receive verbal information rather than collecting information from leaflets. Distance to the practice and continuity of caregiver seemed to conflict for respondents. CONCLUSIONS: Preferences change in the process of ageing and growing health problems. GPs and their co-workers should be also aware of the changing needs of the elderly regarding non-medical attributes of GP care. Meeting their needs regarding non-medical attributes of primary health care is important to improve the quality of care.

[Clothing make the doctor--patients have more confidence in a smartly dressed GP]. / De kleren maken de dokter--meer vertrouwen in netter geklede huisarts.

OBJECTIVE: To investigate the influence of the general practitioner's style of clothing on the patient's level of confidence in that doctor; is vanity a functional attribute for the GP? DESIGN: Experimental comparative study. METHOD: 4 photographic models representing 4 types of GP, namely the older male, younger male, older female and younger female GP, were each photographed dressed in 4 different styles of clothing (business wear, formal, semi-formal and casual). These photos were shown to evaluators with the question 'How much confidence do you have in this doctor?' The level of confidence was allocated a score on a numerical scale from 0 (no confidence) to 10 (complete confidence). There were 2 groups of evaluators: patients aged ≥ 65 years and professionals attending a symposium. RESULTS: The clothing style had a significant impact on the level of confidence in the older and younger male doctor and in the younger female doctor. The assessment by elderly patients (n = 116) differed significantly from the assessment by professionals (n = 59). The professionals had a far more pronounced opinion on style of clothing than the patients did. Business wear and formal clothing generally inspired more confidence than casual clothing. CONCLUSION: A GP's style of clothing affects the patient's initial level of confidence in that doctor. Vanity therefore seems to be a functional attribute for the GP.