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Katherine Lambos Wilsey, Psy.D., is a 2020 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • Roger L. Peterson, PhD, Committee Chair
  • Vincent Pignatiello, PsyD, Committee Member
  • F. Alexander Blount, EdD, Committee Member

Keywords

integrated primary care, missed appointments, academic medical center, primary care behavioral health, patient-centered medical home

Document Type

Dissertation

Publication Date

2020

Abstract

Missed appointments in primary care clinics is of import given the significant impact not only on patients’ continuity of care, but also on the larger healthcare system. Missed appointments indicate that there are barriers to patients’ access of health care and these contribute to poor health outcomes. Further, missed appointments lead to financial and capacity issues for primary care clinics while also contributing towards higher patient utilization of emergency department services, for medical problems traditionally treated by primary care. Integrated primary care clinics offer both medical and mental health services to patients by way of employing behavioral health consultants to assess and improve each patient’s whole health. Prior studies sought to understand patient demographics of those who missed primary care appointments in order to identify patients most at-risk and to subsequently create interventions to best support these individuals. However, there is limited research examining why patients miss appointments; in other words, patients’ reasons for missed appointments. The present study, an interpretive phenomenological qualitative analysis (IPA), examined an archival dataset containing transcripts from semi-structured interviews with patients who missed their scheduled appointment in order to explore the phenomenon of patients missing their appointment at an integrated primary care clinic. The impacts of missed appointments on both individual and systemic bases are discussed. Limitations of this study are considered and directions for future research are suggested. Last, a reflection of my experience as a trainee at an integrated primary care (IPC) clinic that is also an academic medical center (AMC) and a patient-centered medical home (PCMH) is discussed.

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Katherine Lambos Wilsey

ORCID Scholar ID# 0000-0003-0050-6215

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