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Table 2 Patient and provider perceptions of primary care physician and nephrologist care

From: Minding the gap and overlap: a literature review of fragmentation of primary care for chronic dialysis patients

Author, Year

Perspective

Summary Finding

Bender & Holley, 1996 [14]

Nephrologists

Confident as primary care provider: 92%

Alexander et al., 1998 [25]

Dialysis patients

Physician type not associated with patient satisfaction of care

Zimmerman, 2003 [17]

Nephrologists

Confidence in abilities

• Confident in own ability to provide primary care: 60%

• Not very confident in Family Physician (FP) knowledge and training to provide primary care: 46%

• Not very confident in FP available time to provide good primary care: 51%

Roles and responsibilities

• Nephrologist should not provide all PC for dialysis patients: 80%

• Provision of primary care should be…equally split: 40%

  nephrologist has more responsibility than FP: 18%

  FP has more responsibility than nephrologist: 42%

Family Practitioners

Confidence in abilities

• Not very confident in Family Practitioner’s knowledge and training to provide PC: 40%

• Not very confident in Family Practitioner’s available time to provide good PC: 62%

• Nephrologist should not provide all PC for dialysis patients: 85%

Roles and responsibilities

• Nephrologist should not provide all primary care for dialysis patients: 85%

• Provision of primary care should be…equally split: 34%

  nephrologist has more responsibility than FP: 17%

  FP has more responsibility than nephrologist: 40%

Dialysis patients

Adequacy of their physicians training and time to address non-dialysis related problems

• Training – Nephrologists: 46.5% Family physicians: 68.5%

• Time – Nephrologists: 36.6% Family physicians: 68.5%

Green, 2012 [15]

Dialysis unit staff:

 • Nephrologists,

 • Physician Assistants

 • Nurse Practitioners

• Prior training on symptom treatment for pain (44%), depression (41%), sexual dysfunction (82%)

• Non-nephrologist providers should be responsible for managing pain (59%), depression (82%), sexual dysfunction (63%)

• Somewhat or very comfortable treating pain (69%), depression (69%), sexual dysfunction (48%)

  1. Abbreviations: PC Primary care, PCP Primary care provider, FP Family Practitioner