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June 29, 2018

Seeing the Same Doctor over Time: ‘a Matter of Life and Death’

Seeing the Same Doctor over Time: ‘a Matter of Life and Death’

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Seeing the same doctor doesn't only provide a reassuring and familiar face—it could save your life.

Patients who see the same doctor regularly have lower death rates, a study suggests.

Researchers at the University of Exeter analysed the results of 22 studies from nine countries with different health systems. 18 of the studies found people who saw the same doctor over time had significantly lower death rates.

From this, the researchers deduced that the human aspect of medical practice was ‘potentially life-saving’ but often overlooked.

However, the correlation between cause and effect is yet to be established. The relationship may be that those with poor health tend to see more different doctors, due to their specialist needs, but the studies did attempt to account for this.

Doctor shortage

Doctors’ leaders say they recognise the value of patients seeing their ‘own’ doctor. Because of intense workforce pressures, however, this could mean waiting even longer for an appointment, says the Royal College of GPs.

Continuity of care is especially beneficial to those who suffer from chronic health conditions or long-term mental health issues and complex needs.

Furthermore, studies have shown that those who see the same doctor regularly are more likely to follow medical advice, take up preventative care—such as vaccinations—and have significantly fewer unnecessary hospital admissions.

‘When a patient sees a doctor they know and get on with, they talk more freely and give that doctor much more relevant information, sometimes quite personal information or anxieties they have, and the doctor can then tailor the advice and management plans much more subtly,’ says Sir Denis Pereira Gray, who worked on the Exeter University research.

But the shortage of doctors is making it increasingly challenging to provide patients with the care and attention they need. According to a recent study in England, the chance of seeing a doctor in 2017 fell by 27 percent between 2012 and 2017.

The importance of continuity in healthcare

The importance of continuity is seriously underappreciated in health systems, says Pereira Gray. ‘It’s seen in hospitals and general practices as a kind of convenience to give the patient they want to see,’ he says. ‘It’s becoming clearer that this is about the quality of medical practice and is literally a matter of life and death.’

Professor Philip Evans, from the University of Exeter Medical School, says: ‘Continuity of care happens when a patient and a doctor see each other repeatedly and get to know each other.

‘This leads to better communication, patient satisfaction, adherence to medical advice and much lower use of hospital services.’

A holistic approach

Many general practices are trying out new approaches, says vice-chair of the Royal College of GPs (RCGP) Prof Kamila Hawthorne, such as patients being assigned a group of healthcare professionals, including a doctor, who had access to their records and could build relationships with them. 

She said: ‘Balancing continuity of care with timely access to GP services is a huge challenge for general practice. And ultimately the answer is more GPs and more resources for the profession.’

NHS England has pledged £2.4 billion extra a year for general practice and 5,000 more doctors by 2020.

The RCGP said these must be delivered to safeguard the future of general practice and patient care.