Freeman G K, Richards S C
Primary Medical Care, University of Southampton.
Br J Gen Pract. 1994 Sep;44(386):395-9.
So far no study has shown that patients with a chronic illness benefit from seeing the same doctor in general practice although many believe this to be so.
Epilepsy was chosen as an example to test the hypothesis that if patients see the same doctor more often in general practice they are more likely to discuss personally important aspects of their illness.
In this cross-sectional survey 99 patients aged 15-84 years with active epilepsy were interviewed at home and then their records were reviewed. The patients came from four large Southampton group practices, one with a strict personal list system and three with combined lists. Outcome measures included reported discussion of feelings about stopping medication, stigma and concealment and the patient's relationship with practice doctors. Continuity was assessed from the records.
Discussion of epilepsy was not significantly associated with continuity of doctor but was significantly associated with ease of talking to one or more doctors.
Encouraging patients with epilepsy to see the same doctor may be less important than improving doctors' communication skills and paying specific attention to the psychosocial aspects of epilepsy as well as to seizure control. It is recommended that a simple checklist including these items is used when a patient's care is reviewed.
尽管许多人认为慢性病患者在全科医疗中看同一位医生会受益，但迄今为止尚无研究表明情况确实如此。
以癫痫为例，检验以下假设：在全科医疗中，患者更频繁地看同一位医生，就更有可能讨论其疾病中对个人重要的方面。
在这项横断面调查中，对99名年龄在15 - 84岁的活动性癫痫患者进行了家访，随后查阅了他们的病历。这些患者来自南安普敦的四个大型全科医疗团队，其中一个采用严格的个人名单系统，另外三个采用联合名单系统。结果指标包括报告的关于停药感受、耻辱感和隐瞒情况的讨论，以及患者与全科医生的关系。连续性从病历中进行评估。
关于癫痫的讨论与医生的连续性没有显著关联，但与与一位或多位医生交谈的难易程度显著相关。
鼓励癫痫患者看同一位医生可能不如提高医生的沟通技巧以及特别关注癫痫的心理社会方面和癫痫发作控制重要。建议在复查患者护理情况时使用包含这些项目的简单清单。
