CONTINUITY OF CARE CRITICAL TO GOOD HEALTH
Family doctors traditionally see their patients more often than any other physician. That’s a good thing! When a patient is sick or injured, he or she thinks first about seeing their primary care physician. The family doctor and his/her patients often get to know each other rather well—more so than with most specialists. Thus, the patient develops a higher level of comfort and confidence in the family doctor. The ongoing, personal relationship between patient and professional is called “continuity of care.” It is the result of years of interacting and sharing health experiences and the nurturing of a feeling of confidence and reliance on one another. It eventually is the means by which a patient manages chronic health problems and remains in the best health possible.
Study after study has shown continuity of care to be the defining characteristic of primary care and is the tonic that keeps family medicine at the forefront of lower costs and quality care. The patient consults the family physician first for just about any conceivable illness or ailment. The physician’s ongoing/long term relationship with the patient results in better outcomes as well as lower costs and expenses. Family physicians have known this to be true for decades, but now there is hard evidence to prove it.
During the years 2002 to 2022, there were 83 scientific articles written on continuity of care. Researchers evaluated them and found that interpersonal continuity was associated with significantly lower healthcare costs and more favorable outcomes 68% of the time. What this means to patients is that because of the long-term, diligent supervision by one’s family physician, costs of healthcare are less and more efficient use of time and money is realized. Total costs, hospital costs, and primary care costs were all decreased the more the family physician was involved in care management. Decreased antibiotic expense was noted and duplicated medications were avoided. Overuse of the emergency department was avoided and patients were hospitalized only if absolutely necessary.
These outcomes are favorable both to the patient and the system. This comes in spite of the increased use of urgent care centers and many people not having a family doctor. However, those who experience continuity of care by their family physician have fewer ER visits, fewer hospitalizations, and lower costs. Proper guidance is given and unnecessary tests and procedures are avoided.
Dr. G’s Opinion: This conclusion is a no-brainer. The family doctor’s knowledge of the patient from a continual, long term relationship is known to save money and reduce unnecessary emergency visits and hospitalizations. Plus it just plain nice for the family doc to advocate for the patient, when the work up is headed in the wrong direction. This saves time, frustration, and money and results in better outcomes.
References: Medical News in Brief: Review finds Benefits of Primary Care Continuity. JAMA 2023 June 27;329(24):2119.
Bazemore A, Merenstein Z, Handler L, Saultz JW The Impact of Interpersonal Continuity of Primary Care on Health Care Costs and Use: A Critical Review. Annals Fam Med 2023 May/June;21(3):274-279.
Bazemore A, Petterson S, Peterson LE, Bruno R, Chung C, Phillips RL. Higher Primary Care Physician Continuity is Associated with Lower Costs and Hospitalizations. Annals Fam Med 2018 November/December;16(6):492-497.
