The Value of Specific Knowledge: Evidence from Disruptions to the Patient–Physician Relationship.

This article examines the impact of primary care provider (PCP) turnover on patient healthcare utilization and team productivity within the Military Health System (MHS), leveraging quasi-random PCP deployments as an exogenous source of turnover. The study finds that PCP discontinuity leads to a 3%–5% increase in overall healthcare utilization, primarily driven by increased specialty care referrals and more intensive specialty visits, without corresponding improvements in patient outcomes such as hospitalization or emergency department visits. Effects are more pronounced among patients requiring complex care coordination, such as those with diabetes or multiple comorbidities. The findings highlight the role of trust and specific knowledge embedded in the doctor–patient relationship and suggest that turnover imposes costs beyond direct replacement expenses by reducing access to critical, non-transferable knowledge within care teams.