Continuity or access in patient care?

Patients often complain in general practice that they cannot see their own doctor. There is no problem with access but it is continuity of care that is lacking.

GP’s used to pride themselves knowing their patients and families well. In our practice we have 12,000 patients. We used to have six fulltime partners- that is 2,000 patients each. Now for the same number of patients there are 3 full time partners, 2 part time partners, 1 full time salaried doctor, 2 part time salaried doctors, a GP registrar, an F1 doctor and innumerable locums.

I saw a 12year old boy last week that had recurrent severe abdominal pains over 3 months. He had seen consulted ten doctors. He had seen two out of hours doctors, visited casualty twice, seen a specialist, and had consulted five doctors at our practice. He had lost lots of time at school and was on regular painkillers. The parents had no complaints about the doctors attention but they felt nothing had been achieved to relief his suffering or find the cause. I tended to agree, as the symptoms seemed genuine although difficult to explain. No professional had stood back at look at the whole story.

A call to the paediatric consultant was needed to get him admitted and sorted. I felt if he had one doctor who could have seen the pattern and knew the family well he could have been sorted out quicker. That is the job of a good family physician