The value of continuity documented

We generalists often know that continuity of care leads to better outcomes. However, we can not always prove what we know! This article (courtesy of Kevin, M.D.) gives us the evidence. Having a Family Doctor Equals Better Care

People who rely on their primary-care doctor to coordinate their health-care needs fare better than those who don’t, a new study finds.

And family physicians who coordinate their patients’ care are less likely to get sued for malpractice than doctors commonly believe, a second study contends.

Both papers appear in the March/April issue of the Annals of Family Medicine.

“There is evidence that people who see the same doctor over time get better care,” said Dr. John W. Saultz, lead author of the first report and a professor and chairman of the Department of Family Medicine at Oregon Health & Science University.

In their study, Saultz and colleague Dr. Jennifer Lochner looked at data from 40 published studies. Using these studies, they analyzed 81 different patient outcomes for a variety of medical problems.

Among these patient outcomes, 51 were significantly improved when patients maintained a long-term relationship with their primary-care doctor. Only two were worse — tonsillectomy and advice about hormone replacement therapy. The rest were about the same when patients switched doctors often, the review found.

In addition, having a long-term relationship with a doctor resulted in fewer hospitalizations and other reductions in health-care costs, the researchers found.

I will make the leap and assume that general internists (also often primary care physicians) would have the same results.

Another expert agrees that a strong relationship with your primary-care physician means better care — and for the doctor, less risk of being sued.

“We know from prior literature that meaningful relationships between provider and patient also greatly mitigate the risks of litigation,” said Dr. David L. Katz, an associate clinical professor of public health and director of the Prevention Research Center at Yale University School of Medicine. “Suing a trusted, long-valued health-care provider is quite a different matter from suing some nameless technician.”

Taken together, these two studies make an important case that cuts to the core of modern medicine, Katz said.

“Even in this age of medical ‘miracle and wonder,’ much still depends on the human connection that is the historical foundation of medical practice,” he said. “With that foundation, we can, and should, confidently build new approaches to care that enhance outcomes, without undue worry about what the lawyers will think.”