The doctor-patient relationship is fundamental to quality family practice. How much do we know about it? How much do we treasure this relationship? What do our patients or clients think about doctor-patient relationship?

Before we contemplate a good doctor-patient relationship, continuity of care is a prerequisite. Continuity in this context implies the patient consulting the same clinician as time goes by. It is through this process that a constructive relationship between the patient and the doctor is fostered over time. Together with communication skills, continuity of care is probably the most important tool of family practice just like the scalpel of a surgeon.¹ Continuity of care can lead to better knowledge and a better sense of responsibility and trust between patient and doctor.^2,3 This has benefits for both patients and doctors. Patients' empowerment and compliance with treatment are enhanced when the clients "know the doctor well",^4,5 and consulting their "personal doctor" increases patient satisfaction.⁶ Moreover, the doctor-patient interaction itself can have therapeutic value.⁷

However, sometimes continuity is interpreted (or misinterpreted) in another way. In a group practice setting, medical records or computerisation of records may give us a false sense of security as far as continuity is concerned. Since the doctors with access rights can use the records in the subsequent consultations, some people may assume that continuity of care is not interrupted. However, if one thinks about it more critically, the contents of the medical records are in a way "static descriptions", whereas the process of the doctor delivering his care to a patient is a dynamic one. In fact, we are talking about separate levels of continuity: one is on a personal basis and the other is by individual team as in the hospital setting. From the patient's perspective, continuity of care involves human interaction that can only be dealt with by the same individual doctor for the same patient. We may have heard from our patients that they would rather wait for us returning from holidays than see a locum doctor standing in for us at the time. This may seem a bit unfair to the colleague standing in for us, but that is what personal doctoring is about. One way to ensure continuity of care at the individual clinician's level is to operate a so called "personal list" for each doctor of the group practice. This has got its own trade-off, accessibility.

So much has been mentioned about the continuity issue. The research activities in this area so far are doctor-centred. With the emergence of better-informed patients and increased consumerism, doctors are facing clients with more medical knowledge and higher expectations. Nevertheless, a recent study in the UK revealed 64% of the responders to a questionnaire reported that a personal doctor was very or extremely important.⁸ A personal doctor was highly valued by the patients especially for serious, psychological or family issues with almost 90% of the responders placing greater value on a personal doctor-patient relationship more than a convenient appointment. On the other hand, it was less valuable for minor ailments.

Patients may view the importance of continuity of care differently in different clinical situations. Overall, personal care is more highly valued than convenience for more serious problems. As family doctors, we ought to treasure the rapport and the doctor-patient relationship that we have established with our patients. These are the basis which enable us to serve them better.