- Page navigation anchor for RE: Importance of continuity of careRE: Importance of continuity of careWe congratulate Ridd et al.1 on an interesting approach to cancer diagnosis in general practice, but were disappointed that in 2015 they could write: “Seeing the same doctor is associated with higher patient satisfaction but evidence that it makes a difference to patient outcomes is weak.” First, patient satisfaction is itself a major patient outcome, not something separate.The scientific difficulty in researching patient- doctor relationships, like all human relationships including marriage, is that prospective randomized trials are often unethical and that much of the available evidence is hence observational and a series of associations. However, two RCTs have been done and both were positive for continuity of care. 2-3Numerous international studies reveal that continuity of generalist care is significantly associated with better compliance,4 better care for people with diabetes,5 the development of trust in medical generalists by patients,6 provision of more personal preventive care,7 significantly fewer hospital admissions for elderly ambulatory care,8 and lower all-cause mortality.9There are only three possibilities: continuity of care has beneficial outcomes for patients, harmful outcomes, or it makes no difference. The large number of studies reported are not in...Show MoreCompeting Interests: None declared.
- Page navigation anchor for RE: Getting to know patients in the NHSRE: Getting to know patients in the NHSPatients had been on my list here in 1975 for 4.1 +/- 3 years. In 1992 the figure was 10.1 +/- 8.2 years, and the five-year cohorts were predictably very different from each other. Robin Pinsent acknowledged the comings and goings of younger patients as a sort of froth, but non less a challenge to get to know the need of the individual with respect to diagnosing and managing the whole medical picture as well as its parts. The tiny element of not doing that more quickly by a week for one part (cancer) contrasts with the massive issue of serving the needs of the whole population whether they want it or not. Small partnerships and solo GPs who aim to improve the quality of care which they provide are evidently better at doing this if they have a stake in their business enterprise. In any salaried service there is less incentive for improvement.Competing Interests: Founder and first editor of SPA news, SE England faculty new, Northern Home Counties faculty news, Beds & Herts faculty news.