The New Face of Family Medicine

For those of you who had a family doctor prior to the year 2005, you may remember walking into an office with a small, cramped waiting room facing a secretary’s desk piled with patient charts. Beyond the waiting room, you could find a narrow corridor, leading to a few examination rooms, in one of which you would encounter your grumpy family doctor, who likely would only have all of three minutes to assess your health concern and send you on your way. All of this trouble, despite your 2 hour wait in that little waiting room and 3 week wait prior to making this appointment. I am sure we have all experienced this very scenario, myself included.

In the late 1990s and early 2000s, there were many issues facing primary care in Ontario. First of all, there was a growing shortage of family physicians and deteriorating patient access to care.  Many Ontarians did not have family doctors and the ones who did, were often unable to get an appointment with them in a timely manner. Family physicians were overworked and unhappy and medical students were choosing other specialties instead of family medicine.

Studies show that countries who have strong primary care systems (which refer to your initial contact with health care, primarily your family doctor), have healthier populations and use their health care resources more efficiently. With this important theory in mind, the Canadian government set out to change the face of family medicine and called this Primary Care Reform. Among the provinces, Ontario has been the leader in its approach to improving primary care. Since 2002, Ontario has introduced three models of primary care:

1) Family Health Networks –  consisting of groups of family physicians

2) Family Health Groups – a minimum of three physicians joining together to provide primary care

3) Family Health Teams – a team of doctors, nurses, nurse practitioners and other healthcare professionals

The goal behind this change was to increase patient access to primary care, reduce emergency  department and walk-in clinic visits, and better manage chronic diseases like diabetes, hypertension, mental illness, and chronic obstructive pulmonary disease (COPD).

Among these three models, family health teams (FHTs), of which I am a part, provide the most comprehensive care to patients. FHTs give patients better access to healthcare  services by incorporating other healthcare professionals into the team. FHTs can include nurses, nurse practitioners, dietitians, social workers, and pharmacists who are all involved in the care of patients in the team.

So what does this mean to you as a patient if you were enrolled with a family doctor in a family health team? It means that you will continue to see that family doctor during regular office hours for check-ups and treatment of health issues, but in addition to this, you have access to other means of care. If you needed to be seen by a doctor and your physician is not available that day, you are able to see another physician in the team during the day or after hours without having to go to the emergency department or walk-in clinic. Your own family doctor will then get notified that you were seen by another physician in the team and will be able to follow up with you if needed. By sharing after-hours care among the doctors in the team, your own family doctor will have more spots in his or her schedule for same day appointments for patients who really need them. If you have a health question and your family physician is not able to speak to you immediately, you will still have access to medical advice over the telephone with one of the nurses on the team. In addition, there will be free dietician led classes to promote healthier lifestyles. If you needed counseling, you will have access to OHIP-covered counseling services with the social worker on the team. A pharmacist will be available onsite to clarify any drug interactions in patients taking multiple medications.

This very different model of primary care has resulted in many positive outcomes.  More medical students are choosing family medicine as their post-graduate field and more patients have family doctors. We now have over 200 family health teams across Ontario servicing 2.8 million patients. Family health teams and similar primary health groups have reduced visits to emergency departments significantly and improved outcomes with respect to chronic disease management, disease prevention and health promotion.

As a family physician in a family health team, I sleep better at night knowing my patients are taken care of when I am not available now that I have an entire team to help optimize my patients’ health. Being healthy is not just about getting a prescription when you are sick. It is about preventing illness before it starts and making informed decisions that empower patients to lead healthier lives.  If you find a suitable family physician and primary care setting, primary care could be the gateway to a healthier life.

If you do not have a family physician, there is a free service through the ministry of health called “Health Care Connect”.  This service connects patients to a family physician who is taking on new patients in their area. For more information, you can go to the following link:

http://www.health.gov.on.ca/en/ms/healthcareconnect/public

Alternatively you can call, 1-800-445-1822 to request a family physician.

For more information on family health teams:

Family Health Teams (FHT) Inquiries

Toll Free: 1-866-766-0266

Email: FHTinquiries.MOH@ontario.ca

For a list of family health teams across Ontario, go to the following link:

http://www.health.gov.on.ca/en/pro/programs/fht/fht_progress.aspx