More health teams, less red tape: How to make comprehensive family medicine attractive again

Creating more family health teams could help fix the growing problem of burnout among Canada’s family physicians and ease the country’s worsening healthcare crisis, the Ontario Medical Association stressed in an online press event, this week. Cutting out much of the “red tape” for family doctors can also make a big difference in easing their administrative burden. “The reality is, most family doctors . . . they might have a nurse and a receptionist but really, they're on their own,” said Dr. David Barber, chair of the OMA’s section of family and general practice. “If we can surround a family doctor with a team of health professionals, that will de-burden the family doctor during the day. As an example, when people come in with low back pain. There’s no reason why that patient can’t be first seen by a physiotherapist.” An OMA press release noted that only 30% of family doctors in Ontario practise with government-funded team support. The association wants the province to give all family doctors and their patients access to government-funded primary care teams that include nurses, administrators and allied healthcare professionals, and the government should fund these teams, according to the release. “If we change the system a bit, we can make family doctors more efficient,” said Dr. Barber. “It'll make (doctors’) life and work more enjoyable and we can make family medicine attractive to medical students once again.” Read: Just like the public-school system: Mandated rostering among the ideas heard in health-teams session Dr. Kamila Premji, an Ottawa family doctor who’s part of the INSPIRE Primary Health Care (INSPIRE-PHC) research collaborative at Queen’s University in Kingston, Ont., said providing team support could encourage more doctors to practise comprehensive family medicine. Data analyses by INSPIRE-PHC have found a growing reluctance among family doctors to embrace comprehensive, cradle-to-grave family medicine. In 2008, close to 80% of family doctors in Ontario dedicated most of their time to comprehensive primary care, said Dr. Premji. Fast forward 14 years and that number has declined to just 65%. “The common narrative is that it's mainly new graduates who are choosing not to practice this type of primary care,” said Dr. Premji. “But what we see in our data is that the shift away from comprehensive family medicine is occurring across all physician career stages. This includes mid-career physicians and late-career family doctors as well.” Ontario introduced the model of family health teams in 2019 and rolled out 57 across the province. In May 2023, it announced funding for 18 more teams. That’s not enough, said Dr. Mekalai Kumanan, a family doctor in Cambridge, Ont., and president of the Ontario College of Family Physicians. Read: Alberta Opposition NDP promise health teams to improve access to family physicians “Ontarians are faced with an untenable situation,” she said. “We know that the shortage of family doctors is one of the biggest issues facing our healthcare system today and already we've heard that there are more than 2 million people across this province who don't have a family doctor.” In addition to pushing for more health teams, the OCFP is also asking the province to work with family doctors to eliminate “unnecessary red tape.” “As an example, we're calling on Ontario to pass legislation prohibiting employers from requiring a doctor's note for occasional absences, as has already been done in Nova Scotia,” said Dr. Kumanan. “We also need to see a change to forms. Family doctors spend a lot of time filling out lengthy disability forms that are not standardized, and making referrals for services like massage therapy.” Many of these tasks are unnecessary, she added. “So cutting these tasks out will ultimately free up more time for family doctors to spend with our patients.” Read: Clinicians ‘all alone’ when integrating digital health advances

More health teams, less red tape: How to make comprehensive family medicine attractive again

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