The “Own Doctor” Problem: Continuity, Rotating Residents, and the Patient Nobody Knows

Part 4 of Structural Inequity in Prenatal Care

A Black woman on Medicaid in a large American city will see an average of four to six different providers across her prenatal visits. She arrives in labor as a stranger to the team that receives her. The care is clinically supervised. But nobody knows her. Continuity of care is not a courtesy in obstetrics. It is a clinical variable with measurable effects on outcomes. The evidence on who receives it -- and who does not -- is not comfortable reading. obmd.com

I want to tell you about a specific clinical problem that rarely appears by name in the maternal health equity literature, even though it is embedded in almost every statistic about racial disparities in prenatal care. It is called the continuity-of-care gap, and it works like this.

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