The reality of family medicine has changed. The health system must keep up

In Walkerton, Ont., a new family medicine practice accepting patients drew a line of hundreds of people, some waiting in the cold as early as 2 a.m. One person described securing a family doctor as “winning the lottery.”

A new study from Health Canada says we are short a jaw-dropping 23,000 family physicians in this country. We need more doctors – especially in primary care. But that alone won’t solve the system-wide capacity issue we’re facing. We need to scale up new models of care in which health professionals support each other in coordinated, cooperative teams.

Last week, I was in Halifax, where Canada’s health ministers met to discuss our country’s health care needs. Organizations representing Canada’s physicians and nurses came together to highlight that first and foremost, health care is a human resources system – one where we can’t afford to lose any more caregivers. Supporting, retaining and investing in health-care workers is crucial.

The federal government has taken a step in the right direction with a new interpretation of the Canada Health Act. In a letter in January, federal Health Minister Mark Holland clarified that provincial/territorial health insurance should cover medically necessary care from nurse practitioners, midwives and pharmacists as well as physicians.

Language such as “physician-equivalents” included in the interpretation letter is causing confusion and should be clarified. Doctors play a unique role in our health-care system that can’t be duplicated. Simply asking provinces and territories to foot the bill for more siloed, fragmented health services will not address the access-to-care gap plaguing the health system either.

But while the role of family doctors is a fundamental part of primary care, not every problem requires a family doctor, whether it’s managing certain chronic illnesses or refilling specific medications. Working together in teams, health providers can optimize resources – easing the pressure on physicians and the larger public system, while responding to community needs.

It’s important that Minister Holland reiterated that charging patients for medically necessary health services will result in financial penalties for provinces and territories. Patients shouldn’t have to pay out of pocket to work around a struggling health system.

In fact, on a cross-country listening tour about the balance of public and private health care in Canada, the consensus was that access to health care, regardless of the ability to pay, remains a bedrock value. And Canadians are ready for more team-based primary care. In a national survey conducted by OurCare, 90 per cent of respondents said they’d be comfortable seeing another member of a health-care team if a doctor or nurse practitioner recommended it.

Eradicating lineups like the ones in Walkerton requires urgent action on many fronts. This includes funding digital solutions to assist clinicians in their work and ensuring we can access critical health information across systems. It also includes improving doctors’ mobility through pan-Canadian licensure, reducing the administrative burden placed on family doctors, and greater accountability.

Opening the door to publicly funded, team-based primary care where all professionals are recognized is a welcome start. Now urgent investment is needed to make this standard practice, so every Canadian can be assured access to a primary care team.

It’s time to break down the siloes in health care and focus on collaboration instead. No one wants to leave patients out in the cold.

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Dr. Joss Reimer is a public health and maternity physician in Winnipeg and president of the Canadian Medical Association.

This article was originally published on Healthy Debate.