Continuity of Care

Continuity of care from my perspective involves the primary care physician, not an assistant but the physician himself. Know thy patient. Communicate with the patient. Return phone calls promptly. Be available.

As a primary care physician, secure in advance an understanding with your specialty consultants: that when you refer a patient, you will have access to and remain involved in the care, that as the primary, you will read and write notes on the hospital chart, (Somebody has to read the nurses notes) that you will receive written consultations and summaries of care in a timely way, that you must approve of any secondary referrals, that your patient be charged fairly according to his or her means, that you will assist but not interfere with the specialist’s care. (This entails making hospital rounds, often without pay, but in the long run it pays off)

Specialists, especially the best ones, welcome these assertions as a refreshing breath of old fashion medical ethics. They will welcome the agreed-upon source of referrals and consultations. Surgeons especially will recognize a reduced liability from your presence and from the added continuity of care your presence brings. They will treat you and your patients with deference. Although they will most likely refer you patients, do not make that a stipulation.

These guidelines of professional ethics once dominated and still play within organized medicine at the county level.