Towards a new understanding of provider continuity.

Provider continuity is in need of an expanded definition that is not exclusively clinician centered. Currently, provider continuity is defined by visits over time to the same clinician. Many patients and informal caregivers, however, are co-providers of health care, not merely consumers. As a result, provider continuity will not happen if there is a lack of consistency in who attends with or for the patient during successive visits. Such fragmentation may weaken knowledge of the patient and information exchange. Consequently, there is a need to redefine provider continuity to mean that the same attendees visit the same clinician(s), service, or facility as an uninterrupted succession of events. More than semantic quibbling, the proposed reconceptualization challenges the foundation of family medicine in terms of the values and language by which the discipline defines itself in clinician-centered ways. The change required has implications for practice and research.