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July 2018

Seeing the same doctor is a matter of ‘life and death’

A ground-breaking study has concluded that patients who see the same doctor over time have lower death rates.

The study is the first ever systematic review of the relationship between death rates and continuity of care. The study, a collaboration between St Leonard’s Practice in Exeter and the University of Exeter Medical School, analysed all the available evidence in the field to draw its conclusions.

Sir Denis Pereira Gray, of St Leonard’s Practice, said: ‘Patients have long known that it matters which doctor they see and how well they can communicate with them. Until now arranging for patients to see the doctor of their choice has been considered a matter of convenience or courtesy: now it is clear it is about the quality of medical practice and is literally “a matter of life and death”.’

Professor Philip Evans, of the University of Exeter Medical School, said: ‘Continuity of care happens when a patient and a doctor see each other repeatedly and get to know each other. This leads to better communication, patient satisfaction, adherence to medical advice and much lower use of hospital services.

‘As medical technology and new treatments dominate the medical news, the human aspect of medical practice has been neglected. Our study shows it is potentially life-saving and should be prioritised.’

The study found that repeated patient-doctor contact is linked to fewer deaths. The effect applied across different cultures, and was true not just for family doctors, but for specialists including psychiatrists and surgeons as well.

The review analysed the results of 22 eligible high-quality studies with varying time frames. The studies were from nine countries with very different cultures and health systems. Of those, 18 (82%) found that repeated contact with the same doctor over time meant significantly fewer deaths over the study periods compared with those without continuity.

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Pereira-Gray D, et al. BMJ Open 2018;8:e021161

July 2018