Patients would have a 'medical home' under system envisioned by family doctors - Metro US

Patients would have a ‘medical home’ under system envisioned by family doctors

TORONTO – Canada’s family doctors have released a blueprint calling for patient-centred care and timely access to care for all Canadians.

The College of Family Physicians of Canada envisions a personal family doctor for every person in Canada by 2020 and family practices that serve as the “patient’s medical home.”

“We think that there has been a fall-off in the quality of care that has been provided for Canadians because of the difficulty accessing and navigating the system,” said Dr. Calvin Gutkin, CEO and executive director of the college, which represents more than 26,000 family physician members across the country.

“It starts in the family physician’s office for most people in Canada, and the continuity of care that needs to be assured to tie all of their services together has really faced major challenges over the last couple of decades. It’s time to basically rebuild and strengthen that part of the system.”

Dr. Rob Boulay, president of the college, said all Canadians should expect to have a family doctor and the co-ordinated services of other health-care professionals, including nurses, pharmacists and specialists.

“The defining feature of the patient’s medical home is that it is patient-centred. It is responsive to patients’ attitudes, their preferences, their experiences – really it focuses more on person-focused rather than disease-focused care,” he said Tuesday from Moncton, N.B., while en route to Ottawa for the unveiling of the document Wednesday.

“We think that with a multidisciplinary approach and with an approach towards same-day access for appointments and also for enhanced after-hours access that we can really help Canadians to get the type of primary care that they’ve really wanted for quite some time.”

Both Boulay and Gutkin said that some of these concepts have already been implemented in parts of Canada – for instance, through primary care networks in Alberta, family health teams in Ontario and family medicine groups in Quebec.

Boulay, who practises in Miramichi, N.B., said not every doctor can practise in a team, but they have to surround themselves with other health-care professionals, and perhaps have a virtual team to rely on when they’re in geographically isolated areas.

Gutkin noted that electronic records are important in this vision of health care, and there is frustration about the pace at which they’ve been introduced.

Improvements are coming, according to Richard Alvarez, president and CEO of Canada Health Infoway, an organization created by the First Ministers a decade ago to speed the use of electronic health records.

A Commonwealth Fund study a couple of years ago indicated that only about 37 per cent of family doctors in Canada had electronic records, he noted, but an infusion of $500 million in federal money a year ago is helping.

Of that amount, he said $340 million is going toward accelerating the adoption of electronic medical records by clinicians.

“We hope that by the end of this fiscal year, which is the end of March, to have 60 per cent of family physicians starting to use these systems.”

But Alvarez said Canada is still lagging behind countries like New Zealand, Australia and Britain.

He attributed the delays to issues of costs, fear of change and doctors who are busy and don’t have time to convert their systems. In addition, there are concerns about what products to select, and about support for the products.

“What’s going to happen here is that there’s a whole host of physicians who I suspect might retire before they actually adopt these systems,” Alvarez said.

“Certainly the medical students coming into the practice will not practise without these types of automated systems.”

In terms of new doctors, Boulay noted that the college is encouraged by the increased interest in family medicine in recent years, adding that 34 per cent of medical students picked it as their first choice this year – a big increase over the past decade.

The college also has its eye on the health accord between the federal government, provinces and territories, which ends in 2014, and is urging that any new agreement maintain and enhance support for primary care.

“If that support falls off of the table, there will be a significant risk to the ultimate delivery of family practice and primary care services across the country,” Gutkin said.

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