Dr. Karena Hanley:

They will not be attuned. One will not have unity of the practice message and one will not have unity of the practice objective and vision. That practice objective and vision must be to care for the patients. One of the unique things about general practice is that there is a mutual investment by both patient and doctor in a continuity of care over the years. This is a rich therapeutic problem-solving relationship which begins to really spin efficiencies as the doctors and practice nurses know their patients. There is a loyalty and a continuity of care. If one fragments that and loses that dedication to the general practice vision and objective within that practice, one will have lower productivity and worse outcomes than one has in the tight ship that a good general practice is.