Continuity of Care Isn’t Just Nice to Have, It’s a Behaviour Change Tool
Lifestyle medicine consultations rarely change behaviour in one sitting. The real work happens in the follow‑up: the small adjustments, the honest “how did that actually go” conversation. That requires someone to still be there next time. A new whole‑of‑population study out of the Australian National University, published in the Medical Journal of Australia, has put some solid numbers behind that instinct, and the numbers aren’t especially encouraging.
Using seven years of linked Medicare and 2021 Census data covering 19.4 million people, the researchers measured continuity of care with the Usual Provider Index: the proportion of a person’s GP visits that go to their main provider. “High continuity” was defined as 70% or more of visits with the same GP. Across the study period, only around a third of Australians who see a GP regularly (four or more visits in two years) hit that mark. It crept up slightly after 2020, likely linked to telehealth expansion, but sits at 35.5% in the most recent data (2022–2023).
Why this matters for behaviour change, specifically
Every one of the six lifestyle medicine pillars, nutrition, physical activity, sleep, stress management, avoiding risky substances, social connection, depends on an iterative process rather than a single prescription. Motivational interviewing works best with a practitioner who remembers what was tried last time and why it didn’t stick. Tracking a graded increase in physical activity, or working through a lapse in alcohol reduction, needs continuity of context as much as continuity of person. When a patient sees someone new each time, the conversation resets to square one: retelling the history, rebuilding trust, re‑establishing that it’s safe to admit the plan didn’t work. That’s expensive in consultation time, and it’s exactly the kind of friction that stalls behaviour change.A pro‑equity pattern, with some real gaps
There’s a genuinely reassuring finding buried in here: continuity is higher among the patients who arguably need it most, older people, those with chronic conditions, and people in more disadvantaged areas. That’s a rare example of a health system feature working in a pro‑equity direction. But it isn’t all good news. Continuity drops sharply with remoteness (from 36.3% in major cities to just 15.3% in very remote areas), and is measurably lower for women than men (adjusted prevalence ratio 0.90). If you’re running an LM practice in a regional or rural area, or seeing a lot of women managing chronic conditions, this data suggests your patients are statistically less likely to have the stable, single‑provider relationship that behaviour change work tends to rely on.
A few things worth sitting with
This is a large, rigorous, government‑funded study (Australian Institute of Health and Welfare and the Medical Research Future Fund, no industry ties), but it’s observational and cross‑sectional. It describes the pattern without proving what’s driving it: doctor availability, booking systems, deliberate patient choice, or something else entirely. It also doesn’t measure lifestyle medicine outcomes directly, only continuity itself, so the link to behaviour change here is our clinical reasoning laid over solid data, not something the study tested. And the Usual Provider Index only captures continuity with one specific GP, not continuity within a practice or care team, so a patient moving between two familiar doctors at the same clinic could show up as “low continuity” while still receiving genuinely coordinated care.What it means for practice
If your booking system defaults to “next available,” it may be worth building in a nudge toward “usual provider” for anyone in an active behaviour change program. Registering patients through MyMedicare, where appropriate, is one lever already available. And it’s a useful data point to bring into conversations about funding models and appointment length: continuity isn’t just about patient satisfaction, it’s infrastructure for the actual clinical work lifestyle medicine practitioners are trying to do.
Continuity won’t fix itself, but naming it as part of the mechanism of behaviour change, rather than a nice extra, gives us a stronger case for protecting it in how we structure care.
Source: Welsh J, Freeman-Robinson R, Butler DC, et al. Continuity of Care in General Practice in Australia: A Whole-Of-Population Serial Cross-Sectional Study. Medical Journal of Australia. 2026;224:e70229.
Roni Beauchamp
GCertEd, GDipMgt, MPPM
Roni is ALSM’s Chief Executive Officer. Prior to joining ASLM, Roni was the Director Operations, Heart Health with the National Heart Foundation of Australia, having worked in several roles with the Heart Foundation over the past eight years. Her professional interests include public policy, strategy, and leadership as well as a pursuit of better understanding of the human psyche and its impact on behaviour change for health reasons. Originally from the NSW snowy Mountains, and then the Victorian Alps she maintains a keen interest in improving health outcomes for people outside of the key metropolitan areas and of those who are disadvantaged in any way. Prior to moving to the Not-for-profit sector in 2013, Roni worked in a range of senior and executive roles in local and state government throughout Victoria. She holds a Master of Public Policy and Strategic Management.
