The Commonwealth Fund Annual Report

	Increasingly, patients want and expect physicians to treat them as partners in care decisions, be responsive to their concerns, and provide the information and support needed to help them manage their own care. Photo: Roger Carr
	Printable version of this article (4 pages)

he Commonwealth Fund launched the Patient-Centered Primary Care Initiative in 2005 to spur the redesign of primary care practices and health care systems around the needs of the patient. Projects supported by the initiative seek to promote:

	The collection of information on patients' experiences with health care, and the public reporting of that information as a way to encourage quality improvement in primary care.
	The adoption of models, and tools to help primary care practices restructure and improve care to meet patients' preferences.
	Improvements in policy that support patient-centered care.

Despite being named one of the key components of quality health care by the Institute of Medicine (IOM), "patient-centeredness" has yet to become the norm in primary care. One of five American adults has trouble communicating with

doctors, and one of 10 feels he or she was treated disrespectfully during a recent health care visit.⁽¹⁾ The Commonwealth Fund 2006 International Survey of Primary Care Physicians shows that less than half of U.S. physicians receive feedback from patient surveys and just 9 percent always or often communicate with patients via e-mail.⁽²⁾ A little over a quarter use electronic medical records in their practices.

In the essay, "A 2020 Vision of Patient-Centered Primary Care," Karen Davis, Stephen C. Schoenbaum, M.D., and Anne-Marie J. Audet, M.D., outlined what it will take to orient physician practices around patients.⁽³⁾ The authors define a patient-centered primary care practice through seven attributes:

	superb access to care
	patient engagement in care
	clinical information systems supporting high-quality care, practice-based learning, and quality improvement
	care coordination
	integrated and comprehensive team care
	routine patient feedback to doctors
	publicly available information on provider performance.

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Melinda K. Abrams Senior Program Officer