'Two sides of the coin'--the value of personal continuity to GPs: a qualitative interview study.
BACKGROUND
Continuity is thought to be important to GPs but the values behind this are unknown.


OBJECTIVE
To explore the values that doctors working in general practice attach to continuity of patient care and to outline how these values are applied in practice.


METHODS
In-depth qualitative interview with 24 GPs in England. Participants were purposefully sampled according to personal and practice characteristics. Analysis was thematic, drawing on the constant comparative method.


RESULTS
The majority of doctors valued doctor-patient, or personal, continuity in their everyday work. It was most valued in patients with serious, complex or psychological problems. GPs believed that through their personal knowledge of the patient and the doctor-patient relationship, personal continuity enabled them to provide higher quality care. However, the benefits of personal continuity were balanced against problems, and GPs identified personal, professional and external constraints that limited its provision. GPs seemed to have resolved the tension between the benefits, limits and constraints they described by accepting an increased reliance on continuity being provided within teams.


CONCLUSIONS
Personal continuity may offer important benefits to doctors and patients, but we do not know how unique its values are. In particular, it is not clear whether the same benefits can be achieved within teams, the level at which continuity is increasingly being provided. The relative advantages and limits of the different means of delivering continuity need to be better understood, before further policy changes that affect personal continuity are introduced.
Ridd
Matthew
M
Academic Unit of Primary Health Care, University of Bristol Cotham House, Cotham Hill, Bristol BS6 6JL, UK. m.ridd@bristol.ac.uk
Shaw
Alison
A
Salisbury
Chris
C
D000328:Adult; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D036301:Qualitative Research; D006113:United Kingdom