Like loving parents who maintain their attention and presence with children from birth throughout adulthood, continuity of care in medicine offers the benefits of caring, understanding, and wise counsel.

Patients who maintain a relationship with their primary care physician have demonstrably improved safety, satisfaction, and overall health outcomes. Even cancer patients who continue to see to their primary care doctor benefit from the care of non-cancer diseases like heart, lung, diabetes, and other chronic conditions. In many cases, these illnesses are more likely to be fatal than the cancer itself, which may have been cured.

For physicians and other health care providers, continuity of care has benefits as well. Knowing a patient well gives us perspective when it comes to end-of-life decisions and in guidance through the common problems throughout the life span. Understanding patient preferences, respecting their choices, and helping them to make well-informed, patient-centered decisions. This helps them improve adherence to therapies, proper choice of treatments, and decisions about aggressive treatment versus watchful waiting of health risks.

For we professionals, continuity is highly enjoyable and contributes to our daily work satisfaction to meet with a treasured, longtime patient. We use our encounter to catch up on family, job, and friends. This kind of social glue improves the interaction and undergirds the routine but essential medical and lifestyle care choices that need to be made. Such visits are so much more efficient, timely and productive than the “start from the beginning and tell me your whole story” type of visit that is often sandwiched into a compressed 20-minute time slot.

The other side of this is the conjoint journey of suffering we make when we see a patient decline or die with dementia, cancer, heart disease, and other illnesses. Being there with them as a witness and companion to their suffering is sometimes the best we can do when there are no further effective medical management options. If we know them well, we can help them not only with physical pain but also with suffering and the spiritual dimensions of our mutual brief earthly existence.

Hospitalists and other tertiary specialists attend to the immediate pressing and life-threatening issues. But once the tide has turned, it is in the context of continuity of care that chronic problems, immunizations, routine screenings, social and psychological support occur.

The hyperfragmentation of our health care system into body parts, micro-specialties, and technological procedures makes our American health care system the most expensive and one of the least effective in the world. The Canadian system, for example, costs half as much per capita as ours with better overall outcomes on multiple measures.

On the other hand, continuity of care, the deep and lasting relationship of a patient or family with a pediatrician, internist, family physician, or other primary care provider provides a powerful and proven way to bend the curve on this high-cost, high-risk, low-outcome care that is dissatisfying to both patients and providers.

So if you want to make steps to improve your health outcomes, engage in a continuity of care relationship with a primary care provider. This should be someone you trust who can serve as your partner, advocate, guide, coach, counselor, and navigator through the complexity of our dysfunctional health care system.