Patients' perceptions on losing access to FPs: qualitative study.
Bibliographic record
Abstract
OBJECTIVE: To examine the health care-related experiences of individuals who have lost their FPs. DESIGN: A qualitative design using phenomenology. SETTING: Southwestern Ontario. PARTICIPANTS: Eighteen participants (9 women and 9 men, with a mean age of 48.9 years) from urban or rural areas who had lost their FPs. METHODS: Semistructured interviews were conducted, which were audiotaped and transcribed verbatim. An iterative approach using immersion and crystallization was employed for analysis. MAIN FINDINGS: Participants reported having lost their FPs because of reasons specific to their physicians (eg, illness, retirement, career change) or system issues (eg, poor remuneration for FPs, cutbacks in health care leading to physician emigration). Participants described feelings of loss, abandonment, frustration, and anger related to losing their physicians. They expressed concerns about the difficulty of getting prescription medications, lack of continuity of care related to medical records, and preventive care. They faced considerable hurdles in accessing primary health care, turning to walk-in clinics and emergency departments despite concerns about quality and fragmentation of care. Some of those with chronic medical conditions prevailed upon specialists to help meet primary health care needs. CONCLUSION: Losing access to FPs evoked a variety of strong feelings among these participants. They engaged in a number of strategies to meet their primary care needs but not without reservations. In a health care system appropriately built on primary health care, the lack of access to FPs is regarded as the loss of a basic right to care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.005 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".