To Disrupt Healthcare, Maybe Consider Listening To A Doctor

By Jamie Wells, M.D. — Nov 13, 2018
The systematic erosion of continuity of care has financial and personal health costs. This is well-known, especially to health professionals, and it's supported by overwhelming evidence. And yet, it persists.
Credit: publicdomainpictures.net

In what is simply proving to be a redundant exercise at this point, new research published in the Annals of Family Medicine supports much existing evidence that greater continuity of primary care is associated with reduced hospitalizations and lower costs. The erosion of the relationship between the key stakeholders, doctor and patient, by ballooning third party involvement along with forced implementation of the glorified billing platform that is the electronic medical record (that in reality marginalizes meaningful patient data) and regrettable perverse payment incentives has gone unchecked and been complicit in further fracturing care.

Supporting the doctor-patient relationship could yield superior dividends. Of critical import in medical practice is doing things the right way the first time. Shortcuts have financial and safety consequences that reverberate in a negative chain reaction.

We know this. Yet policies still emphasize later clean up rather than avoidance altogether. And costs mount – from monetary ones to adverse personal outcomes.

For more evidence on the benefits of continuity of care and the extent to which fragmenting care is so unnecessarily corrosive, review these pieces and the accompanying data that echoes this reality.

  • "By Not Seeing The Same Doctor, You May Be Risking Your Life" (read article here)

In BMJ Open’s “Continuity of care with doctors - a matter of life and death? A systematic review of continuity of care and mortality.” Researchers performed a comprehensive analysis of existing literature on the subject and found:

  • Continuity of care (COC) is “associated with increased patient satisfaction, increased take-up of health promotion, greater adherence to medical advice and decreased use of hospital services.”
  • 82% of high-quality studies show significant reductions in mortality with increased COC - this significant protective effect spanned generalists and specialist doctors
  • Vast majority were for all-cause mortality (repeated patient-doctor contact meant fewer deaths)

This message is also amplified in the following articles:

The assault on the doctor-patient relationship continues and has the most egregious ramifications on the system, cost and public health. For example, read here about the impact of urgent care centers on antibiotic resistance and the lack of continuity of care these markets promote. There are a number of contributing factors to this issue, but health care professionals have been voicing their concerns to no avail. In the meantime, while hoping for the pendulum to swing back, review this guide to being your own advocate in healthcare as a way to empower yourself and help close some loopholes generated by our current system.

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