Monthly Archives: December 2009

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Report urges improved access to primary care

A report produced by the College of Family Physicians of Canada and the Canadian Medical Association this week promotes the goal of 95 per cent of the population having a regular family doctor by 2012.

According to a recent public opinion poll for the Canadian Medical Association, coverage currently stands at 82 per cent.

The two medical associations say there are two ways of reaching the ambitious 95 per cent target: increasing the number of physicians practicing in the country, and increasing physician’s capacity to take on more patients.

However, these two measures are unlikely to allow the goal to be reached in time. It says more medical students should be encouraged to choose family medicine. While there has been some movement in this direction, most students still opt to become specialists.

It also recommends the integration of foreign-trained physicians in the workforce, something the provinces are doing. But physicians wanting to immigrate to Canada will not benefit from a new federal-provincial-territorial accord streamlining the recognition of foreign credentials until the end of 2012.

The report largely deals with how to help physicians make their practices run more efficiently and take on more patients – not just urging them to “work harder and longer.”

It says teaching physicians to run a practice from a patient-flow point of view should start in medical school, and there are a number of techniques already being used that are bearing fruit. This includes “advance access” scheduling that leaves a physician’s schedule open for same-day appointments.

Wait times for primary care are an issue, and the reports says measuring these waits should be a priority for governments even though it is difficult to break this information down by the myriad reasons patients have for seeking an appointment.

Team-based care is another approach that is being used to improve patient care, but, as an instrument for improving access, the report says the jury is still out and more research is needed.

The two medical associations say tools to improve the timeliness of referrals to specialists also need to be enhanced. They point out that research undertaken by the Fraser Institute finds that half the total waiting time for care is the interval between when the family physician makes a referral and when the patient is actually seen by the specialist.

They say good professional relationships between family physicians and specialists should be promoted and supported in the health system.

Reference:  Health Edition – December 4, 2009. Volume 13 Issue 48

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