Do patients like continuity of care? Or is it that folk favour a fresh pair of eyes and a new team looking at things?
There's been an irritating practice of late, in my corner, that as soon as someone turns 65 years old, they're referred from their existing working age adult mental health services, to mental health services for older people, and to me. It's flagrantly outwith our Trust's graduation policy, they're all read, shredded and filed carefully in the bin with a succinct letter back to the referrer, but it got me thinking.
Locally, patients we asked favour staying within existing services and didn't want to move on the basis of age alone.
Happily, 2 local audits of working age adult patients (well, they were called audits, but they were surveys) found that patients feel the same way that I do. If they've clinical reasons for being under my care, with stuff that I can do better, I'm keen to snaffle them on over to my corner. If they've no reason to transfer care, I'm keen for them to stay with their existing team.
Surely transfer of care on basis of age alone, not clinical need, is flirting dangerously with age discrimination, no?
Unless they dislike the doctor, most patients seem to prefer continuity of care. A relationship built over time surely has more value to the patient and the doctor than a single clinical encounter. The patient has the opportunity to build trust in their doctor; but I think the benefit of having clinicians who know their patients well enough to recognise illness from the minutest of changes is generally under-rated.
When life is all over the place, continuity of care provides a little welcome stability.
Coincidentally, someone today mentioned a local MH team who apparently deliver a 'seamless, ageless service'. Sounds good to me...the less fragmentation, the fewer communication cock-ups!
I think it is discriminative too. I much rather staying with people that i have build relationships with.
I also believe that the continuity is vital. I've been with the same psychiatrist for nearly 14 years now... I'm not convinced that I would get better treatment from someone who specialized in adults rather than someone specializing in children.
I'm sure the guy gets great pride in watching his patients grow up (both in age and in ability) and succeed in their lives. That;s the sense I get from talking to him.
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