RE: continuity

After 40 years in family practice--30 in solo private practice and, after a brief hiatus, ten more with IHS, both in one location with one practice--continuity of care is of paramount importance not only for the relationships and trust it builds but for the long-term coordination of care of the FAMILY over multiple generations. Medical home was a cornerstone of my practices before the world came up with the term. I think medical home has always been practiced by primary care physicians even before it became a speciality in a national attempt at legitimization.

My other thought is that I was appalled by the adoption of specialty fellowships by the family practice academy. This to me is antithetical to the term family practice. Where is the continuity over a lifetime, over an entire body of health? If doctors want specialty fellowships they should skip family practice and go into those fellowships. Just my humble opinion.

I also agree the community needs to be a major part of the health of our patients. Too many of my patients came to me from other physicians because the physicians would not treat non-whites or mixed-race couples or LGBTQ patients or patients of different religions. This must be rooted out at the residency level. There is no place for discrimination in family practice.