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December 3, 2018

Long-term Physician-Patient Relationships—Persevering in a Practice

Author Affiliations
  • 1Department of Medicine, The University of Chicago, Chicago, Illinois
JAMA Intern Med. Published online December 3, 2018. doi:10.1001/jamainternmed.2018.6735

Few physicians or patients question that a stable, long-term physician-patient relationship is a good thing. Despite this, these relationships are increasingly rare. The demands of electronic documentation, the stress created by the myriad ways that patients can access their physicians today, and the declining reimbursement for primary care all make maintaining a long-term practice challenging. At the same time, our increasingly mobile society and the restrictions on physician choice imposed by payers make remaining with the same physician difficult for a patient.

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    2 Comments for this article
    Healthy Patient Avoidance of Physician Visits
    Helen Hunt, MA | N/A
    Some people who are advancing in age are healthy and strong, without risk factors other than age. In medical jargon, they may meet criteria of "ideal cardiovascular health". Rather than schedule physician appointments, they may place great value on adhering to healthy food consumption, frequent exercise, healthy weight and waist size, maintaining healthy blood pressure - which they monitor themselves and can improve by increasing vigorous exercise or dietary approaches, etc. False positive test results or inappropriate medical interpretations or diagnoses can be a nuisance which healthy people may wish to avoid. So a question arises: Can a strong healthy person who is advancing in age best avoid inappropriate medical "findings" or pharmaceutical prescriptions by not showing up at a physician's office?
    Continuity of care.
    Michael Plunkett, M. D., M. B. A. | Solo practice
    Well thought out and well written.

    Having been in practice for 42 years now I fully agree with Dr. Cifu’s thoughts. I have some four generation families in my practice and it’s very rewarding. And, as stated, as the practice matures it’s a little painful to lose these wonderful people. But I think it’s a comfort to them and their families to have “their doctor” there for them at the end.

    As the article states the future is less certain.
    I fear my children and grandchildren will have no
    one to care for them. And I mean CARE.

    When I was at the University of Chicago, Dr. Marc Siegler gave a talk on “curing versus caring.“ I think today’s talk would be “documenting versus compliance.“ i’m not so sure caring is very high on any medical school professor’s agenda today.