Doctor argues for doctor-patient continuity over healthcare queues

The ongoing debate surrounding Sweden's healthcare system predominantly centers on waiting times, patient choice, and the role of private providers. However, physician Fanny Nilsson contends that the most fundamental and critical issues are being overlooked. In her view, the true crisis lies in the absence of a consistent doctor-patient relationship and the uncertainty of securing a hospital bed when ill.

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The question is strange for most Swedes. You meet different people every time. Having your own doctor sounds like something from a bygone era, when a doctor took care of an entire community, or was the private doctor of the well-to-do.

Nilsson, whose insights are featured in Dagens Nyheter, highlights the concept of "relationship continuity," where patients see the same doctor regularly. She argues this is vital for preventing both mortality and unnecessary hospitalizations, particularly for elderly patients with multiple chronic conditions. This contrasts sharply with the common Swedish experience of seeing different doctors for each visit.

Drawing from her own experiences and extensive research, including a six-month sabbatical across Europe, Nilsson has documented her findings in the book "Go to the ER. How much healthcare can we afford?" Her work suggests that prioritizing continuity of care could lead to a healthier, more secure population and potentially reduce healthcare costs. She points to Norway's "fastlegereformen," which established a primary care physician for all citizens, as a successful model.

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The results from the trips and interviews are presented in the book "Go to the ER. How much healthcare can we afford?"

Studies from Norway and Denmark, published in reputable journals like The Lancet, indicate that patients with a long-term doctor experienced a 25% lower risk of death and a 30% lower risk of seeking emergency care compared to those who had seen the same doctor for only a year. Nilsson emphasizes that beyond these measurable outcomes, the relationship and trust built between a patient and their doctor are foundational elements of effective healthcare, fostering a sense of security that is often lost in fragmented systems.

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The patients who had had the same doctor for 15 years, compared to 1 year, had a 25 percent lower risk of dying, and a 30 percent lower risk of seeking care outside of office hours – going to the ER.