Hard evidence regarding diagnosis, care, and management of this area of practice is, unsurprisingly, hard to come by. It is disappointing that the article by Chew-Graham et al does not specifically mention the importance of personal continuity of care in these cases, and the desirable development of trust of a patient with a clinician.1 Fragmented care at best makes management of patients with these conditions difficult. Without trust, satisfactory explanation, and understanding, a positive impact is much less likely. At its worst, fragmented care can act as a reinforcement rather than a relief of symptoms.
Only with this recognition, and appropriate dedicated review opportunities within the GP appointment system (perhaps into which ONLY the GP is authorised to book), can desirable continuity be achieved (continuity was given prominence with several articles in BMJ 2017; 356).
- © British Journal of General Practice 2017