Assessing Rural Family Physicians Performance According to Healthcare Managers, Family Physicians, and Patients in Golestan Province, Iran

Background and The family physician is the first point of contact between people and health system (after the health workers) that should be capable of providing first-class services. The aim of this study was to investigate the performance of family physicians. A cross-sectional study was conducted in 1956 patients, 110 family physicians, and 70 health managers. Check lists and questionnaires were used to collect the data. The check list included different dimensions such as education, service delivery, performance management and community participation. Also, a questionnaire was used to study about the relationship with patients and health management of the region. Data was analyzed in SPSS V.18 applying ANOVA, T-Test and Pearson Correlation. According to the family physicians and health managers, the strongest and weakest dimensions were performance management and health management of the region. Among the patients 48.9% reported a good physician-patient relationship. There were significant relationships between age of the family physicians and community participation (P=0.044), their sexuality and education (P=0.019) and community participation (P=0.02), the town where family physicians work and service delivery (P=0.029), and their employment statuses and the health management of the region (P=0.001). We found significant relationships between the sexuality of managers and community participation (P=0.001), services delivery (P=0.008), performance management (P=0.006) and health management of the region (P=0.004). Also, significant relationships were found between the physician-patient relationship and patient’s age (P=0.003) number of referrals (P=0.001), city (P=0.001) and level of education (P=0.009). Despite the fact that dimensions of training, service delivery, performance management, and physician-patient relationship were in appropriate levels but dimensions of community participation and health management of the region need to improve their performance.