TY - JOUR T1 - What do patients want? Generalists versus specialists and the importance of continuity JF - Future Hospital Journal JO - Future Hosp J SP - 75 LP - 76 DO - 10.7861/futurehosp.3-1-75 VL - 3 IS - 1 AU - John Oldham Y1 - 2016/02/01 UR - http://www.rcpjournals.org/content/3/1/75.abstract N2 - Patients have benefitted enormously in recent years through the rapid growth in medical knowledge and the development of new technologies and treatments. The result has been better clinical outcomes and quality-of-life improvements for most patients. A consequence of all of this is that patients are living longer and living with complex comorbidities which put immense strain on health and social care resources. Specialisation and sub-specialisation have changed the way physicians work and the decline in the number of generalists has led to many patients, particularly the elderly, experiencing problems around a lack of continuity of care. They end up attending many different hospital clinics and departments to see different specialists, usually acting in isolation for each condition, and become frustrated at having to tell their stories over and over again. They argue that care programmes are often disjointed and they feel that no one is in charge of their overall care plan.The Patient and Carer Network (PCN) of the Royal College of Physicians (RCP) has over 60 members and they were recently asked to give their views on the problems patients are facing through the rapid growth in medical specialisation and a diminishing number of generalists. Members of the network reported that the biggest problem they experienced or witnessed was a lack of coordination of care. This was often a problem not only between different medical specialists but also between hospitals and departments. They reported that when having many hospital appointments over a period of time for a single condition they ‘saw quite a few doctors but never the named consultant’. One member felt that as patients get older and comorbidities grow, the continuity issue is more of a problem. She added that:Patients … ER -