How Having a Regular Doctor Can Improve Your Health: An Adelaide GP’s Guide

If you are generally healthy, having a regular GP can seem unnecessary. You might book whoever is available when you need a prescription, have an infection or want a blood test, then not think about seeing a doctor again for months.

For straightforward problems, that can work perfectly well.

But there are advantages to having a doctor who knows you over time. They learn your medical history, what has already been investigated, which treatments have worked, what you are worried about and, sometimes, simply how you describe things.

There is also a reasonable evidence base behind continuity of care. People who consistently see the same doctor tend to have fewer hospital admissions and use less urgent care, and some studies have found an association with lower mortality.[1-3]

For me, though, some of the benefits are much more ordinary than those statistics suggest.

You spend less time explaining yourself

Seeing a new doctor often means starting with the backstory.

Why was that medication stopped?

What happened when you saw the cardiologist two years ago?

Was that abdominal pain already investigated?

Was the slightly abnormal blood test new, or has it looked like that for five years?

Why did you decide against a treatment last time?

Sometimes reconstructing that history takes a substantial part of the appointment.

When I know someone already, we can usually get to the current problem much faster. I know what has happened before and the patient does not need to repeatedly explain the same parts of their life and medical history.

This becomes increasingly useful as health becomes more complicated.

Medical notes only tell part of the story

Electronic medical records are extremely useful. I can see diagnoses, medications, pathology results, imaging, specialist letters and notes from previous appointments.

But even very detailed notes have limitations.

A consultation note is one doctor’s summary of a conversation. It records what seemed clinically important at the time. It cannot reproduce every discussion, hesitation, preference or piece of context that went into a decision.

A note might simply say:

“Discussed options. Patient prefers to monitor for now.”

There may have been a long conversation behind that sentence.

Perhaps they previously had a bad reaction to a medication. Perhaps treatment would interfere with their work. Perhaps several options were considered and there was a good reason to wait.

The next doctor can read what was written down. Someone who was part of the original conversation has more of the context.

And sometimes the information that builds up over time is difficult to put into a medical record at all.

Sometimes you learn how a person communicates

I once looked after a patient who had significant difficulty communicating their symptoms.

They came in one day saying they had “eaten too much”.

On its own, that could have sounded fairly unremarkable. But I knew this patient and understood that this was how they tended to describe abdominal discomfort.

I assessed them further and arranged a CT scan. The findings ultimately led to treatment in hospital.

What stayed with me was how much of the assessment depended on already knowing the person sitting in front of me. Another doctor meeting them for the first time could quite reasonably have interpreted those same words differently.

There was no pathology result or specialist letter that could communicate that piece of information. It came from having seen them before.

Your GP learns what is normal for you

A lot of medicine involves comparison.

A blood pressure of 145/85 means something slightly different in someone whose usual blood pressure is 110/70 compared with someone who has been around 145/85 for years.

The same principle applies to weight, kidney function, liver tests, exercise tolerance, recurrent symptoms and many other parts of health.

Seeing the same GP makes it easier to build a picture over time.

Rather than looking at today’s result in isolation, we can ask whether something is stable, gradually changing or genuinely new.

Sometimes a change that looks small on one appointment becomes much more obvious when viewed across several years.

Preventive healthcare becomes more individual

There is no universal annual blood-test panel that every healthy adult needs.

Preventive healthcare depends on your age, family history, medications, previous results, lifestyle and existing health conditions.

For one person, the priority might be cardiovascular risk and cholesterol.

For another, it might be skin cancer surveillance.

Someone else may need diabetes screening, vaccination review, kidney monitoring or discussion about bowel cancer screening.

A GP who knows your history can keep track of those things over time rather than starting from scratch at each appointment.

It can also reduce unnecessary testing. If I know why a test was done previously, what the result was and whether anything has changed since, there may be no reason to repeat it simply because another year has passed.

What does the research show?

Continuity of care has been studied in several countries and healthcare systems.

A 2018 systematic review looked at 22 studies examining continuity with a doctor and mortality. Eighteen found significantly lower mortality among people with greater continuity of care.[1]

A large Norwegian study involving more than 4.5 million people found that longer relationships with the same GP were associated with fewer acute hospital admissions, less use of out-of-hours services and lower mortality. The associations became stronger as the length of the GP relationship increased.[2]

Research from England has also found an association between greater continuity in general practice and fewer hospital admissions for conditions that can often be managed effectively in primary care.[3]

These studies are largely observational. They show an association and cannot prove that seeing the same GP is solely responsible for the better outcomes.

There are several plausible explanations. Better follow-up, greater familiarity with medical history, earlier recognition of change, fewer duplicated investigations and stronger therapeutic relationships could all contribute.

The findings are also consistent with broader evidence showing the importance of access to primary care. Population-level research has found that areas with greater access to primary-care physicians tend to have better health outcomes, including longer life expectancy.[4]

Having a regular GP does not mean seeing one doctor for everything

There will always be times when your usual GP is unavailable.

If you are acutely unwell, you may need to see whoever can see you that day. Some problems are better managed by another GP with a particular interest or by a specialist. Urgent problems sometimes need urgent care or an emergency department.

Seeing another doctor occasionally does not undo continuity of care.

The useful part is having someone you return to who can keep an overview of what has happened.

For some people that relationship develops with an individual GP. For others, continuity comes from a small group of doctors within the same practice.

You do not need to be sick to establish a regular GP

People often start looking for a regular doctor once something has already gone wrong.

There can be an advantage to establishing that relationship while you are well.

Your GP can learn your history, family risk factors and baseline health. Preventive care can be addressed gradually. If something changes several years later, there is already some context.

That does not mean booking appointments simply for the sake of attending.

It means knowing where you will go when you do need medical care.

Finding a regular GP in Adelaide

If you are looking for a regular GP in Adelaide, I think the most important question is whether you have found someone you feel comfortable returning to.

You should be able to ask questions, discuss uncertainty and feel that previous decisions are understood rather than repeatedly reconstructed.

I work as a specialist general practitioner at Paradise Medical Centre in Adelaide’s north-eastern suburbs. My interests include preventive healthcare, chronic disease, skin cancer care and providing ongoing general practice care over time.

I am currently accepting new patients.

Sometimes good healthcare begins with something fairly simple: finding a doctor who gets the chance to know you.

References

1. Pereira Gray DJ, Sidaway-Lee K, White E, Thorne A, Evans PH. Continuity of care with doctors: a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open. 2018;8:e021161. doi:10.1136/bmjopen-2017-021161.
2. Sandvik H, Hetlevik Ø, Blinkenberg J, Hunskaar S. Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway. Br J Gen Pract. 2022;72:e84-e90. doi:10.3399/BJGP.2021.0340.
3. Barker I, Steventon A, Deeny SR. Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data. BMJ. 2017;356:j84. doi:10.1136/bmj.j84.
4. Basu S, Berkowitz SA, Phillips RL, et al. Association of primary care physician supply with population mortality in the United States, 2005-2015. JAMA Intern Med. 2019;179:506-514. doi:10.1001/jamainternmed.2018.7624.