HealthDay News — Primary care physician (PCP)-specialist cotraining yields changes in specialist care that improve patient experiences, according to a study published online January 3 in JAMA Internal Medicine.
In a quasi-experimental study, Maximilian J. Pany and J. Michael McWilliams, MD, PhD, from Harvard Medical School in Boston, examined whether peer relationships between PCPs and specialists formed during training motivate improved specialist care for patients. To estimate the differences in experience with specialist care reported by patients of the same PCP for specialists who did or did not train with the PCP, a difference-in-differences analysis was used.
Data were included for 9920 specialist visits for 8655 patients, of which 3.1% (306) involved PCP-specialist dyads with overlap in training. The researchers found that the adjusted composite patient rating of specialist care was 9.0 percentage points higher in association with cotraining ties between PCPs and specialists, which was equivalent to the improvement from the median to the 91st percentile of specialist performance. The association was stronger for PCP-specialist dyads with full temporal overlap in training and was consistent for 9 of 10 patient experience items. Furthermore, cotraining was associated with changes in medication prescribing, indicating behavioral changes beyond interpersonal communication.
“The main implication of our findings is that peer relationships could be fostered and deployed to improve quality more broadly and even reduce disparities (e.g., by implementing team care models in community health centers),” the authors write.