Characteristics of Primary Care Safety-Net Providers and Their Quality Improvement Attitudes and Activities: Results of a National Survey of Physician Professionalism

No current national data exist to characterize safety-net physicians and their attitudes toward and participation in quality improvement activities compared with non-safety-net physicians. The authors conducted a national random sample survey of internal medicine, family practice, and pediatrics primary care physicians (PCPs) and used weighted multivariable regression models to assess attitudes and participation in quality improvement activities. After multivariable adjustment, there were no significant differences in provider attitudes about or participation in quality improvement activities between safety-net and non-safety-net physicians. However, safety-net providers were almost twice as likely to look for racial/ethnic disparities in care within their practices and are as likely to be involved in quality improvement activities as non-safety-net providers; their attitudes are consistent with providing equitable and universal care. Increasing access by expanding Medicaid eligibility will require continued investment in the number and training of safety-net PCPs.