Table 2

Sample quotations for each dimension of continuity of care

Chronologic or longitudinal
  • “You know their history; you don’t have to keep asking them the same things over and over again. You also get to follow the progression of the disease.” (R)

  • “It’s kind of traveling down their life road as they hit different challenges and life changes.” (R)

  • “There has to be continuity; there has to be a shared record; there has to be communication. I think that’s an important aspect [of continuity of care].” (FP)

  • “If you don’t have continuity of care, at least having a common chart is helpful to you. At least you know their history.” (EC)

  • “It is connection. It’s building a relationship. It’s more than just having the medical information.” (R)

  • “A picture is worth a thousand words. Meeting is worth a million; it’s a book. There is tone of voice, how they are speaking, the things that are important to them in the conversation.” (R)

  • “I think that [the relationship] is the only thing that’s keeping them coming back to that same person. I think this affects their outcomes because you are the steady.” (R)

  • “One of the things that I really like about family medicine is that I took care of this patient as a kid and now they are growing up and they’re having kids and I get to take care of their kids and grandkids. You develop a nice rapport with them and a strong foundation. You get to know the whole family.” (FP)

  • “You get to know what the context is behind the whole family that really helps in clinical management, knowing what is best for each family member. And there is a good sense of fulfillment when you see the whole family. You are not just one person’s doctor but the doctor for that family unit.” (R)

  • “The idea that you don’t limit yourself to knowing the patient in just one [setting]. He was so excited you were coming [to do a house call] and we see them in hospital.” (FP)

  • “In some situations people would be seeing a variety of care providers for all of these different things, and you can provide them all to the patient.” (FP)

  • “You are even much better [as a doctor] because you can function as you are meant to, as much as your competence allows you, in gynecology, pediatrics, general medicine.” (R)

Community (new dimension)
  • “You get to know what is going on ... the family doctor is really part of the community, they knew exactly what was going on in the community and so they could sort of touch upon it in clinic as well and sort of know what stressors were bothering people and they would be able to take care of their patients better. They’d know the underlying cause of what was going on.” (R)

  • “A second dimension is the idea of community members in your practice telling you about a patient so finding out additional information that way.” (FP)

  • “There is a higher level implicating yourself into the life of the community where you start seeing patterns emerging in different patients as you get to know them and, therefore, you know what is happening out in the community, so you can see patterns of illness and disease based on where people live and what people do for a living, what industries are in town.” (R)

  • “For me continuity [is] getting to know them and actually getting to that person outside of my doctor-patient relationship. Like I play hockey with them or something and that changes not only how I see my patient, but how they see me.” (FP)

Health care team (new dimension)
  • “Continuity isn’t just [about] the one provider, but the continuity of the patient and of all the players.” (FP)

  • “I think it’s really important for us to start sharing that relationship and recognizing that [patients] could equally have strong relationships with other members of the team.” (FP)

  • “A new view of continuity of care is that the family physician [is] sort of being like an orchestra conductor [or] quarterback.” (R)

  • * Quotes from family physicians in comprehensive family practice are identified as FP, quotes from family medicine residents are identified as R, and quotes from family physicians who provide episodic care are identified as EC.