Calling all doctors: Family physicians really need your help

The COVID-19 pandemic affected all physicians in the country, from surgeons having to cancel planned surgeries, emergency rooms filling up with critically ill patients, to primary care clinics trying to balance in-person and virtual care visits. Physicians stepped up to fulfill leadership roles, upskilled to provide services in areas of need, manned assessment centres and have participated in vaccination campaigns, amongst many other efforts to provide quality care. What the pandemic has also done is highlight is the ongoing and longstanding concern with primary care and family physicians. According to a September 2021 assessment of COVID’s toll on family doctors, conducted by the College of Family Physicians of Canada, 15% of family doctors are feeling burned out—a three-fold increase from May 2020. More than half of survey respondents also said they were working beyond their desired capacity, a stark contrast to the 76% of family doctors who had reduced their work hours at the start of the pandemic due to fewer patient visits. Read: What’s really ailing docs these days? It is evident that family physicians need the support and advocacy from all their colleagues. Here are some ways we can do this as a profession: How can we do this as a profession? Look out for each other. If you become aware of a physician colleague who is struggling or needs assistance, reach out to your provincial association’s physician health program. Practice collegiality. If you are a colleague or a specialist, and a family physician phones for advice, please accept the call. Be courteous, be kind. They are not calling to find out what the weather is like in your location – they need assistance. To you it may seem trivial at times, but they are seeking help, and the reason they do so is to enhance patient care. Read: Speed it up! There's a platform linking primary care docs to specialists—and it's really working Be available. If you are a colleague or a specialist on-call, please answer the page. Call your colleague back. They may be just as busy as you are, possibly with less support than you have at your location. Find out what they need—advice or reassurance is invaluable. Accept a transfer when requested. There are often more aspects when reaching out to a colleague or a specialist than what meets the eye—lack of support, lack of capacity, concern about diagnoses, inability to optimally obtain special investigation or imaging, or to treat the patient. Do your part. It is sometimes easier to defer a request for a form or a report to the family physician. Insurance and sick leave forms are often sent back to family doctor to fill in. Many of these are required after procedures or specialist involvement and really fall outside of the scope and experience of family doctors to reliably complete. Be judicious with your requests. Think twice before including advice like “request an ultrasound and send a copy to my office” in a consult note. Think of it this way: If you knew the family physician personally, would you make this request? Or will you respect their time and expertise as much as you do your own? Read: Exhausted and buried alive in an administrative avalanche? Save a step. In communication with a rural, full scope family physician I learned that during the pandemic many specialists followed patients virtually and could not supply the patients with laboratory requisitions for tests such as blood work. Many resorted to asking the family physician to order specific blood work and then copy it to the specialist or even follow-up CTs, MRIs and other special investigations. The same happens with referrals to physiotherapy, occupational therapy, and speech language pathology. Some specialists will evaluate a patient and recommend a referral to another specialty—and then request the family physician to do so. It may be much more efficient for the specialist to request those investigations or make the referrals at the same visit. Practice what you preach. Reciprocity is mutually beneficial. All this works both ways, and all family physicians should practise the same principles in return. Refer and consult appropriately. In Saskatchewan, the College has a referral-consultation guideline that sets out the principles and expectations for the process between physicians, as a number of valuable resources, including standardized referral letters and instructions on setting these up in the EMR. Read: Depressed, suicidal and afraid to get help: Study shows a medical profession in distress Know the billing rules. Some specialists require a yearly re-referral by the family physician to be able to see patients they follow annually and bill a consult code. This step may not be required, but if it is it would be helpful—for you and the family physician—to be aware of the rules so you can provide any required documentation without having to be reminded by the referring physician. Be collegial, be courteous, be kind. Your colleagues deserve it. This opinion piece is not meant to exclude other specialties and the roles they play in the delivery of healthcare in the province. It’s intended to recognize that family physicians remain the cornerstone of medical care delivery, and that they are struggling to maintain the desired quality of care with the additional burdens they face. Let’s all do what we can to help. Read: Need a friend? Sask. program to provide mentor-physicians for new doctors

Calling all doctors: Family physicians really need your help

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