Perceptions of family medicine among long-term patients of a family medicine clinic in Japan: a mixed-methods study

Objectives: To examine the perceptions of family medicine among patients attending a family medicine clinic for over 10 years in Japan and explore the unique characteristics of a family medicine which was developed in the local community in northern Japan.

Design: Explanatory, sequential mixed-method design comprising a survey by questionnaires and semistructured interviews.

Setting: The study was conducted at one of the oldest family medicine primary care clinics in Japan. We surveyed and interviewed participants from November 2019 to March 2020.

Participants: 144 patients who have attended a family medicine clinic since April 2009 completed the questionnaires. Semistructured interviews with nine participants were conducted.

Results: Among the respondents, 131 (91%) reported having attended a family medicine clinic. In terms of their perceptions of what 'family physicians' do, 42 (35%) stated 'a doctor who treats various diseases with a general view', 34 (29%) stated 'a doctor who treats outpatients and visit patients' houses', and 15 (13%) stated 'a doctor whom one can consult for anything and is familiar with one's family and lifestyle'. The results of the qualitative analysis revealed two themes with regard to patients' perceptions of family medicine: 'seeing the whole person and referring suitably' and 'medical care at home'. Patients' perceptions of family medicine identified in the quantitative study were strongly associated with the characteristics extracted from the qualitative study.

Conclusion: Patients attending the family medicine clinic had clear perceptions of what family physicians do. The two major perceptions of the characteristics of family medicine were identified as 'seeing the whole person and referring suitably' and 'medical care at home'.