Ideology and reality of continuity of care

The concept of continuity of care is part of the framework on which the ideology and teaching of family practice is based. The purpose of the present study was to evaluate the ideals and reality of continuity of care as perceived by Norwegian family physicians. A representative sample of 207 physicians answered a mailed questionnaire related to continuity of care. Eighty percent of the physicians found the concept of continuity important or very important to the ideology of family practice. There were, however, significant statistical and clinically important discrepancies between ideals and reality. If standards are too ambitious or unrealistic to achieve, they often become counterproductive. Two basic ways to correct this discrepancy are discussed: improving reality by increasing chronological care and lowering the ideals by de-emphasizing comprehensive care. The ideals of continuity of care in family practice were set more than 20 years ago. As the field of family practice matures, more realistic goals may be indicated to prevent individual professional burnout and loss of credibility as a specialty.