Perceptions of primary care in Korea: a comparison of patient and physician focus group discussions

Background: The primary care system in the Republic of Korea has weakened over the past decade and is now in poorer condition than the systems in other countries. However, little is known about how the two key players, patients and physicians, view the current status of primary care in Korea. This study aims to understand what problems they perceive in respect to the key components of primary care. Methods: We conducted two focus groups; one with six patients and the other with six physicians. We designed and modified the guidelines for each focus group discussion through repeated review and discussion among all authors and then we conducted the groups with a professional interviewer at Gallup Korea. After the focus groups we analyzed the verbatim transcriptions to identify specific meanings and potential implications. Results: From the study we identified that the patients and physicians did not have a correct understanding about the role of primary care. We also identified a significant discrepancy between their perception of primary care. In particular, the patient group perceived the quality of primary care to be poor and unsatisfactory while the physician group perceived the quality of primary care to be better in Korea than in other countries. Conclusions: The focus group discussions revealed that such discrepancies in perception have resulted from Korea's distorted healthcare delivery system, undifferentiated roles among healthcare organizations, patients' freedom of choice in selecting healthcare providers and other institutional factors. There are several steps that should be taken to promote primary care in Korea. First, we should undertake efforts to improve the quality of primary care provided by physicians. Second, we should inform the general public about using clinics instead of hospitals for the treatment of simple or minor diseases. Third, we should introduce a new compensation scheme to compensate physicians for services related to health education, disease prevention, behavioral change and nutrition consultation. Finally, we should provide additional reimbursement so that primary care physicians can extend their office hours to better meet the needs of patients.