title: Continuity of care: differing conceptions and values.
abstract: OBJECTIVE
  To understand how the conception of continuity of care can influence family physician trainees by exploring the perspectives of established family physicians, physicians working in episodic care who had been trained in family medicine, and family medicine trainees.
  
  
  METHODS
  Qualitative analysis of focus group data.
  
  
  METHODS
  Southeastern Ontario.
  
  
  METHODS
  Seven focus groups consisting of members from 3 groups: established family physicians, physicians working in episodic care who had been trained in family medicine, or family medicine trainees.
  
  
  METHODS
  Semistructured focus group interviews were taped and transcribed. Using constant comparison, the transcripts were analyzed for themes related to continuity of care and how these were valued among the 3 groups of physicians.
  
  
  RESULTS
  The 3 groups differed on how they valued continuity of the relationship, how they valued informational continuity, and how these concepts affected their perceptions of difficult clinician-patient relationships. Experienced family physicians described long-term relationships as a core value in their practices. In contrast, episodic care physicians valued informational continuity. Family medicine trainees learned about continuity of care through role models and theoretical teaching. They valued the efficiency gained by knowing patients and the reward of being recognized by patients. Family medicine trainees expressed greater distress with difficult clinician-patient interactions than experienced family physicians expressed. It was unclear whether the challenges of difficult relationships were offset by the trainees' appreciation of continuity of care.
  
  
  CONCLUSIONS
  Different perceptions, settings, and skills can influence how continuity of care is valued, which might affect career and practice decisions among trainees.
authors.affiliation: Dalhousie University, Undergraduate Medical Education, Room C-125, 5849 University Ave, Halifax, NS B3H 4H7. Dianne.Delva@dal.ca
authors.forename: Dianne
authors.initials: D
authors.lastname: Delva
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kerr
authors.forename: Karen
authors.initials: K
authors.lastname: Schultz
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care; D005194:Family Practice / Q000193:education; D005260:Female; D017144:Focus Groups; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010817:Physician-Patient Relations; D010821:Physicians, Family; D036301:Qualitative Research; D012945:Social Values