Face-to-Face Relationships Still Matter in a Digital Age: A Call for a 5th C in the Core Tenets of Primary Care

PLAIN LANGUAGE ARTICLE SUMMARY

Essay    

Adding ‘Contiguity’ as a Fifth Core Tenet: The Irreplaceable Value of Face-to-Face Care in Primary Care 

Background:In the early 1990s, Barbara Starfield identified four core tenets of primary care: first contact, comprehensiveness, coordination, and continuity. However, in today’s rapidly advancing digital world, where telehealth and artificial intelligence are becoming more prevalent, the role of physical presence in patient care is being questioned.

Key Argument:This essay argues for the addition of a fifth tenet, “Contiguity,” which highlights the importance of face-to-face interactions in primary care. Contiguity refers to the physical proximity between a patient and their clinician, which is essential for building trust, conducting thorough physical exams, and fostering genuine relationships. The essay contends that although technology can improve many aspects of care, it cannot replace the unique human connection that occurs when patients and clinicians are physically present with one another.

Why It Matters:As health care continues to evolve with digital innovations, it’s important to articulate the value of physical face-to-face interactions in primary care. By naming contiguity as a core tenet of primary care, health care systems, academic primary care departments, and other policy-generating institutions will be held accountable to ensure that clinicians do not lose sight of this foundational component of patient-clinician relationships. Contiguity ensures care remains deeply personal, trusting, and empathic. 

Face-to-Face Relationships Still Matter in a Digital Age: A Call for a 5th C in the Core Tenets of Primary Care

Jennifer Y. C. Edgoose, MD, MPH, et al

Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin