Seeing the same doctor is a matter of life and death

The study, a collaboration between St Leonard’s Practice in Exeter and the University of Exeter Medical School, is published today in BMJ Open. It is the first ever systematic review of the relationship between death rates and continuity of care - seeing the same doctor over time. The study analyses 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.

This research was conceived and conducted in a single NHS general practice in Exeter, which has the advantage of employing its own postdoctoral research fellow. The practice team includes Professor Philip Evans who holds a leadership role in the National Institute of Health Research Clinical Research Network. The practice was pleased to build up the skills of two medical students so that they were empowered to be co-authors. One of these medical students, Eleanor White is currently in her third year at the University of Exeter Medical School and is a former winner of the Quintiles Women in Science Award.

Eleanor said: "I'm really excited that we have been able to publish our latest finding of an association of continuity of care with lower mortality. Despite continuity being a core value of General Practice, it is often overlooked in health care planning. I hope that our review encourages further research in this area so that continuity of care can be prioritised once again."

The review, Continuity of care with doctors – a matter of life and death? A systematic review of continuity of care and mortality, is published in BMJ Open. Authors were Denis J Pereira Gray, Kate Sidaway-Lee, Eleanor White, Angus Thorne, and Philip H Evans.