Patient-centered care has received new prominence with its inclusion by the Institute of Medicine as 1 of the 6 aims of quality.
Seven attributes of patient-centered primary care are proposed here to improve this dimension of care: access to care, patient
engagement in care, information systems, care coordination, integrated and comprehensive team care, patient-centered care
surveys, and publicly available information. The Commonwealth Fund 2003 National Survey of Physicians and Quality of Care
finds that one fourth of primary care physicians currently incorporate these various patient-centered attributes in their
practices. To bring about marked improvement will require a new system of primary care payment that blends monthly patient
panel fees with traditional fee-for-service payment, and new incentives for patient-centered care performance. A major effort
to test this concept, develop a business case, provide technical assistance and training, and diffuse best practices is needed
to transform American health care.
Key Words patient-centered care - primary care - quality of care
This paper draws on the Malcolm Peterson Honor Lecture given by Karen Davis at the 27th Annual Meeting of the Society of General
Internal Medicine, Chicago, May 14, 2004.