Any family physician will tell you the relationships they develop with their patients are worth much more than money. In today’s medical practice realm, money is of major importance to the financial sustainability of a practice, but to most physicians and patients it falls far down on the list of real benefits. A family physician, at least one who cares, knows his patients like “the back of his hand.” The relationship has been strengthened by many years of visits for various reasons that broaden the doctor’s knowledge of his patient and instills in the patient trust and confidence in the doctor. Any patient with whom a doctor interacts for 10 or 15 years will develop a sense of peace with his doctor, and the doctor will, in turn, have a greater degree of influence on the behaviors and choices of the patient.
To emphasize the power of a long term family physician-patient relationship, medscape.com presented an article based on the results of an observational study from Norway. This study involved patients who had been cared for by the same family physician for 15 years, and observed what effects the relationship had on several factors. The study discovered that patients who went to the same family MD for 15 years had the following:
1. They had a 30% reduction in the use of the emergency room.
2. They had 28% fewer hospitalizations.
3. They had a 25% lower mortality rate.
They used the ER less, stayed out of the hospital more, and died less frequently. These are all good things from the standpoint of costs, expenditures, and utilization. Also the longer the doctor patient relationship lasted, the longer the positives lasted.
I contend these outcomes are a direct result of the depth of knowledge about his patient the FP has gained over the years of their relationship. The doctor has a better sense of the patient’s thinking and is a better judge of the need for an ER visit. The FP knows if a patient favors the anxious side of things or is stoic and would only complain if there were something wrong. The FP has a better sense of a patient’s ability to care for himself at home. He knows who he has at home and if they are able to provide that care. And familiarity is a good barometer for assessing just how sick someone is. There is academic knowledge, but there is also a “sixth sense” that an experienced physician develops.
Disruptions in the continuity of care are associated with higher mortality in patients with chronic conditions. More recent studies have demonstrated that continuity of care has beneficial effects on systolic BP and HbA1c. There is an invisible connection that links the healthcare professional to the patient. That connection establishes trust between doctor and patient. It is a trust that generates success in the therapeutic alliance.”I will do as you say because I trust you.” “I won’t go to the ER unless you tell me to.”
Not using the ER and avoiding hospital admission reduce medical costs. “A strong primary care group [physician] is the foundation of a high-performing health care system…. With better population health….. fewer preventable adverse events [occur]….as well as a more rational use of the system’s resources.” This is the doctrine Family Medicine has preached for 50 years. It hasn’t been accepted as fact by those who reward our work [ie. 3rd party payers]. It’s still procedural specialties that get all the financial attention while family medicine continues to manage patients’ health with no recognition. These data may help to improve our lot, but I’m doubtful it will make a difference.
References: Carpello SC. Continuity With one Family Doctor Cuts Mortality medscape.com 2026 August 5.,
