Improve healthcare: Ensure a team for every family doctor

I have many colleagues who work in fee-for-service, family health group or comprehensive care model practice models. They struggle with complicated healthcare demands for their patients. Why is it fair that some family doctors have access to foot care nurses, dietitians, mental health supports, patient navigators, social workers and pharmacists for their patients while other doctors do not? Why is there two-tiered primary care? The hardest challenges I have heard about are mental health and addictions or dealing with the frail elderly. Remember we are talking about healthcare equity not equality. Some patients in Ontario just need more healthcare supports and that is only possible if all patients have access to the same team-based resources. We need to come up with solutions and then spend our energies “selling” the ideas to those who make policy decisions. Read: Dr. Alykhan Abdulla: Improve health care: Reduce administrative burden Here is the greatest opportunity: Ontario is heading toward an election on June 2, 2022. Many incredible organizations including the Ontario Medical Association, the Section of General and Family Medicine and the Ontario College of Family Physicians have prepared clear guidance based on evidence for improving health care for all Ontario citizens. This is my summary and a challenge to you to amplify the message (if you agree). This is the third of a three part series on improving healthcare at a foundational level. It is not an exhaustive treatise but rather focused on primary care. Investments in primary care have greater value at reducing all-cause mortality and improving all health parameters. Here are the three principles as follows: Ensure every Ontarian gets a family doctor. Ensure family doctors actually deal with patients and not do more administrative work. Ensure every family doctor works in a team. This article will deal with the last point: Ensure every family doctor works in a team. What is the evidence of team-based primary care improving health outcomes and costing less per patient? These references show improved timely access, better coordination of care, and improved management of chronic diseases. Simple facts: Team-based care patients have 40% better access Team-based care patients have 10% better cancer care preventative measures Team-based care patients have better satisfaction in collaborative decision making and dealing with administrative staff. Team-based care patients felt there was better communication , effective care coordination and better system navigation with less conflicting advice. Team-based care patients had better management of chronic diseases. What is the solution? We need more family doctors working in teams in Ontario. Indeed, to absorb 1.3 million orphaned patients we need 1,000 more family doctors (with the assumption that each family doctor can take 1,300 patients). Ontario ranks seventh among Canadian provinces in number of family doctors per 100,000 patients and, if it were a country, would have one of the lowest doctor-to-population rankings among OECD countries (29 out of 33). CHALLENGE: So what can you do (if you want to change things proactively)? Reach out to your MPP or MPP candidate and use the following TOOL KIT Write an op-ed using the messaging of OMA or OCFP Talk to everyone you know that this is a critical issue. Make it an election issue. Dr. Alykhan Abdulla is a comprehensive family doctor working in Manotick, Ont. and a past-chair of the section of general and family practice and lead for longitudinal leadership curricula at Univerity of Ottawa undergraduate medical education. Twitter @AlykhanAbdulla

Improve healthcare: Ensure a team for every family doctor

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