Long-term continuity care: unanticipated consequences, viable solutions

To many researchers, long-term continuity care seems a given. Behind their confidence, however, lie issues of concern. This article addresses the unanticipated consequences of long-term continuity care. It identifies issues such as the liabilities of long-term therapeutic relationships, continuity care diagnostic fatigue, intellectual curiosity fatigue, and the adverse economics of long-term continuity care and the practice setting that fosters "routinized," protocol-driven care, among others. It discusses these issues and suggests ways to mitigate their impact. The authors elicit debate by portraying long-term continuity care as both a problem and a solution, and conclude by making the case for a more perfect long-term continuity care process: one that is safe, efficient, and economically advantageous for all stakeholders.