Discover and read the best of Twitter Threads about #bcprimarycare
Most recents (6)
What happens
when your
family doctor
orders
LAB TESTS
for you?
Another 🧵 about the inner workings of 🇨🇦 primary care (or how the sausage gets made), and how fixing the #familydoctorshortage is not just about hiring more doctors.
@BCFamilyDoctors
when your
family doctor
orders
LAB TESTS
for you?
Another 🧵 about the inner workings of 🇨🇦 primary care (or how the sausage gets made), and how fixing the #familydoctorshortage is not just about hiring more doctors.
@BCFamilyDoctors
Let's say you go to your doctor,
after considering your story (= reason for your visit), your past medical history,
the possible diagnoses/treatments
for the issue,
she decides to order blood work (=evidence-based medicine),
& you agree with that (=shared decision making).
after considering your story (= reason for your visit), your past medical history,
the possible diagnoses/treatments
for the issue,
she decides to order blood work (=evidence-based medicine),
& you agree with that (=shared decision making).
She creates a LAB REQUISITION (="req")
She selects the tests that she thinks will help understand/treat/monitor the issue.
This is based on what she learned in med school, what she learned staying up to date(=Continuing Medical Education) & sometimes, a specialist's advice
She selects the tests that she thinks will help understand/treat/monitor the issue.
This is based on what she learned in med school, what she learned staying up to date(=Continuing Medical Education) & sometimes, a specialist's advice
I think Nurse Practitioners are a part of the solution to the #FamilyDoctorShortage in #BCPrimaryCare and the rest of 🇨🇦
👀
👀
I expect to hear the following "buts"
1- see too few patients
2- spend too much time per pt, cost too much
3- have less training than FP's
And, I agree they are not 1:1 replaceable with FP's
But a "doctors only" fix to Primary Care is so 2019
1- see too few patients
2- spend too much time per pt, cost too much
3- have less training than FP's
And, I agree they are not 1:1 replaceable with FP's
But a "doctors only" fix to Primary Care is so 2019
Team-based primary care with other care providers:
nurse practitioners
nurses
OT/PT
counseling
SW
pharmacist
elders
patient navigators
This is what is going to address the shortages, in a meaningful and sustainable way.
nurse practitioners
nurses
OT/PT
counseling
SW
pharmacist
elders
patient navigators
This is what is going to address the shortages, in a meaningful and sustainable way.
I am a generalist,
full-service family doctor,
working in a clinic
that provides
longitudinal primary care,
and I referred
a few patients
to specialists
this week...
here's how and why that happens 🧵 1/9
(#BCPrimaryCare)
full-service family doctor,
working in a clinic
that provides
longitudinal primary care,
and I referred
a few patients
to specialists
this week...
here's how and why that happens 🧵 1/9
(#BCPrimaryCare)
When I see a patient, we talk about:
-the reason they needed the appointment today
-how life is going in general
-as needed, their other medical history
after I get hear the story
do a physical exam
review old information
We may decide that we need extra advice
2/9
-the reason they needed the appointment today
-how life is going in general
-as needed, their other medical history
after I get hear the story
do a physical exam
review old information
We may decide that we need extra advice
2/9
Sometimes it is:
to confirm the diagnosis or
change treatment or
decide on tests or imaging
consider surgery
etc
I need to formulate a specific question & summarize the patient's condition, history and preferences. I do this both on the fly & after the appointment. 3/9
to confirm the diagnosis or
change treatment or
decide on tests or imaging
consider surgery
etc
I need to formulate a specific question & summarize the patient's condition, history and preferences. I do this both on the fly & after the appointment. 3/9
I am on call for my primary care clinic this week...
What does that mean?
A 🧵 about how
our fee for service (soon to be "group contract") clinic
of 16 clinicians, ~15,000 patients
delivers afterhours #BCPrimaryCare
@BCFamilyDoctors
What does that mean?
A 🧵 about how
our fee for service (soon to be "group contract") clinic
of 16 clinicians, ~15,000 patients
delivers afterhours #BCPrimaryCare
@BCFamilyDoctors
Our MDs and NPs are on call for one week at a time.
Between 5pm-8am weekdays and all weekend,
we need to be ready to
support patients for
URGENT, not emergency issues
that cannot wait until the next business day
that means phone close by at all times
Between 5pm-8am weekdays and all weekend,
we need to be ready to
support patients for
URGENT, not emergency issues
that cannot wait until the next business day
that means phone close by at all times
People call appropriately for:
e.g. sick baby with fever, to figure out does she need to go to emergency or can stay home
or
e.g. strained back shoveling snow and want to know what can do to alleviate pain
I can bill a "telehealth visit: 14x37"
~32$ for call + documentation
e.g. sick baby with fever, to figure out does she need to go to emergency or can stay home
or
e.g. strained back shoveling snow and want to know what can do to alleviate pain
I can bill a "telehealth visit: 14x37"
~32$ for call + documentation
THREAD: Everyone gets a Family Doctor!
This new announcement by the @liberal_party recognizes the value of primary care. liberal.ca/liberals-move-…
And research shows us that access to primary care saves lives!
ncbi.nlm.nih.gov/pmc/articles/P…
This new announcement by the @liberal_party recognizes the value of primary care. liberal.ca/liberals-move-…
And research shows us that access to primary care saves lives!
ncbi.nlm.nih.gov/pmc/articles/P…
Details in the Libs announcement are sparse, but to my BC ears, it sounds familiar ... GP for ME
straight.com/life/630116/gp…
Great idea, pay GP's a special incentive fee to take on more patients and ... everyone gets a GP, problem solved... right?
straight.com/life/630116/gp…
Great idea, pay GP's a special incentive fee to take on more patients and ... everyone gets a GP, problem solved... right?
How do family doctors organize themselves to deliver #BCPrimaryCare?
Seems like a simple ? right... ?
Our @MaapStudy #MAAPBC team is identifying clinics that provide community-based primary care/family medicine.
And we want to group them into types of clinics. 1/x
Seems like a simple ? right... ?
Our @MaapStudy #MAAPBC team is identifying clinics that provide community-based primary care/family medicine.
And we want to group them into types of clinics. 1/x
We started out using the @cpsbc_ca list of all GP's in the areas of interest (all @VCHhealthcare regions).
We identified (by phoning & googling) only those GP's who provide community-based primary care (excluded those people who e.g.just work in hospitals, or are retired) 2/x
We identified (by phoning & googling) only those GP's who provide community-based primary care (excluded those people who e.g.just work in hospitals, or are retired) 2/x
We also used yellow pages, medimaps, google to find listings for "family doctor" or "medical clinic" etc.
Now we have a list of all the clinics that provide community-based primary care in the @VCHhealthcare regions (which we are happy to share!)
@SetarehBani
3/x
Now we have a list of all the clinics that provide community-based primary care in the @VCHhealthcare regions (which we are happy to share!)
@SetarehBani
3/x
