Patientperspektivet på læge-patientrelationen i ... - Dagens Medicin

Introduction
Patients often prefer a long-term relationship with the same general practitioner (GP) [1-3]. There
are a number of explanations for this and continuity of care has been divided into three different
types: informational, management and relational continuity or in other words interpersonal
continuity [4]. Patients value different types of continuity for different reasons [5-8]. There are
certain obvious advantages of informational continuity, like the doctor knowing the patients‟
medical history [9]. It is also obvious that it may be comfortable for the patient to be familiar with
the practice setting and the staff in general. The question is whether there are relational matters
apart from the doctor‟s medical knowledge of the patient that influence the preference for seeing the
same doctor? Many argue that interpersonal continuity is central to good care [10,11], but they have
not provided a theory to explain why. It is argued that general practice needs to turn to the sciences
of human behaviour to develop a theoretical understanding of the value of interpersonal continuity
[12]. This article is based on a qualitative study of the doctor-patient relationship and the purpose is
to explore why interpersonal continuity with a regular doctor is valuable to patients. The research
question is answered by involving psychological theory in the analysis.
Material and methods
This was a qualitative study based on interviews with 22 patients, 12 patients who saw a regular
doctor and 10 patients who saw an unfamiliar doctor. A regular doctor was defined as the doctor the
patient was registered with and having had more than one visit to. The researcher observed
consultations with six doctors in two practices, three doctors were regular doctors, and three doctors
were trainees. The patients were selected after the consultation and purposefully sampled [13]
according to different reasons for encounters, age, sex and their relationship with the doctor. A
semi-structured interview guide was developed based on observation, literature studies, clinical
experiences and discussions in our research group.
Interviewees were informed that they were anonymized. The patients were asked to assess the
observed consultation with regard to their relation with the doctor and to compare the observed
consultation with their experiences with their regular doctor and other doctors. The interviews were
founded on the recent consultation, and therefore we minimised generalised or idealised accounts.
In order to maintain anonymity, all GPs in the article appear as men and patients‟ names are
fictitious.
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