Continuity is fine, but not for everything

EDITOR—With reference to the article by Guthrie and Wyke,1 continuity in general practice is one of those obvious good things, but it is too complicated to be something with an easy answer, an all or nothing. In 1988 I wrote a personal view which proposed that patients might see a different doctor for acute illness than for their long term problems.2 They might even travel to see this personal doctor. This was met with some amazement by some of my colleagues.

The changes in a society that now expects to be able to get money at midnight and shop in Tesco at 2 am (and I am as guilty as anyone else) means that, in places where general practice demand is high, systems have to be developed to cope. So we have walk in centres, triage systems, or duty doctors seeing all those strange things, social, medical, or just “I'm off work today,” that need to be seen now. In quiet places of low demand, …