Defining and Measuring Interpersonal Continuity of Care

I concur with Bruce Bagley. Much of the research around continuity has looked at relationships of relatively short duration. None have examined the implications of Very Long Term Continuity, by which I mean 20+ years of doctor-patient relationship. And despite our nomenclature, no one is looking at the fact that in the course of this kind of continuity we have generational connections with multiple levels of a family: delivering a baby and 2 decades later delivering her baby, as Bruce pointed out. So the continuity is not just 1:1 between doctor and patient, but rather to a whole family. We have not investigated this kind of continuity at all. When we get around to looking at this, I suspect we will find that it not only matters deeply to those of us who do it, but it is also deeply important to those complex multigenerational families we care for.

Competing interests:   None declared

After more than a quarter of a century of full service family practice, I understand continuity in a way that is untouched by the literature. It is about caring for friends, not just patients. It is about diagnosing pregnancy, delivering the baby and watching that wonderful creation of God grow into a fine human being with family, friends, dreams and hopes of her own. Then delivering her baby.

Continuity is such an inadequate word to describe helping a friend (patient) as he faces death, to deal with pain, loss and unresolved family conflicts.

The literature fails to describe what family physicians provide for their patients every day. It is about trust. It is about connecting. It is about knowing the real cause of the "dis-ease." It is about understanding people and providing simple explanations.

I have been blessed in so many ways, but most importantly, thank God, I am a family physician.

Bruce Bagley, M.D.

Competing interests:   None declared