Aboulghate and colleagues, in their analysis of GP Patient Survey data, conclude that most people value continuity but that practices need to flexibly balance it against speed of access.1 Asking patients whether they prefer to see a particular GP invites responses that cannot reflect the complexity of their real decision-making.
We have previously reported a discrete choice experiment study of preferences for access to GPs that showed continuity to be a preference that is context-dependent and of variable importance.2 Patients balance continuity of care against convenience of appointment time and speed of access, according to the reason for their consultation. Those with a long-standing illness value seeing the GP of their choice seven times as much as rapid access, while for those consulting with a child, rapid access is important. Overall, the extra time that patients in this study were willing to wait to see the doctor of their choice was less than 1 day.
Patients weigh up continuity of care as one of several attributes of the health care they require on a given occasion. The access we provide should reflect those values and its quality measured in more sophisticated ways.
- © British Journal of General Practice 2012
