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The Immeasurable Value of Continuity of Care

Today I visited my internist for a checkup and flu shot. We talked about how I’m doing, and she examined me, and we dis­cussed what pro­ce­dures I ought have done and not done. She’s been my doctor since the summer of 1987, when I was an intern at the hospital.

We reviewed so much that has hap­pened in the interim.

How rare it is, now, to have a doctor who knows me. Con­ti­nuity in care is so valuable.

One of my greatest fears is being in the hos­pital again, and having hos­pi­talists – doctors who work full-​​time in the hos­pital – be the ones to see me each day, and make deci­sions about what I need. Yet I’m bracing for it because, well, that’s how it is, now.

From a health care admin­is­tration per­spective, I rec­ognize the value of del­e­gating inpa­tient care to physi­cians who are not my usual doctors. And from the per­spective of a physician who after hours and on weekends, would walk to and from the hos­pital, back and forth, countless times, to see my patients when they were sick, I know it’s neither cost-​​effective nor wise for physi­cians to push them­selves to get over to the hos­pital before or after they’ve gone home, and called everyone back, and maybe eaten dinner. Doctors need rest, too.

But as a patient, when I’ve been in the hos­pital, nothing was more reas­suring than visits by my usual doctors – my internist, my oncol­ogist, my surgeon, my orthopedist…Being cared for by strangers, however com­petent, is not the same, although there may never be a study to prove it.

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