Cover: Consequences of variations in definitions of the primary care physician

Consequences of variations in definitions of the primary care physician

Published 1984

by Jane S. Spiegel, Lisa V. Rubenstein, Bonnie Scott, Robert H. Brook

Purchase Print Copy

 Format Price
Add to Cart Paperback33 pages $20.00

Several studies have concluded that specialists form a hidden system for primary care delivery. These studies, however, assume that a specialist who provides the majority of care is the primary care physician. Using data for a one-year period from 2,752 people enrolled in the RAND Health Insurance Experiment, the authors examine the validity of this conclusion. They compare how three different definitions of a primary care physician affect estimates of who provides primary care: (1) the physician who delivered the "majority of care" (34 percent were specialists); (2) the physician who was designated to receive results of a multiphasic screening examination (12 percent were specialists); and (3) the physician who treated common problems (9 percent were specialists). Thus, the contribution made by specialists is overestimated threefold when the "majority of care" concept is used to define primary care. Definitions of a primary care physician must be more specific, must include tasks frequently associated with primary care, and must take account of patients' perceptions of who functions as their primary care physician.

This report is part of the RAND note series. The note was a product of RAND from 1979 to 1993 that reported other outputs of sponsored research for general distribution.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.