Thread by @DrRitaMc

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…

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?

Except... it didn't work:
timescolonist.com/a-gp-for-me-do… (@cindyeharnett)

because...

1) The GP's providing good primary care were already working to the max, and

2) the rules about who you could bill the incentive for were vague, and what did billing the incentive mean and

3) most importantly, no change to the underlying structure of care delivery was made

No change to the structure:
1) Still vast majority of care expected to be delivered via GP-run businesses and

2) At least 10 years of evidence that most GP's (especially the new ones) don't want to run businesses.

ncbi.nlm.nih.gov/pmc/articles/P…

What do those new grads want?

Good news... all the things we need for primary care to really take off & ⬆️health+⬇️costs (via MAAP-BC.ca):

1) A team environment, incl non-MD team members
2) Ability to take vacation and parental leave
3) A reliable income, paid

So here we are in BC, still 100,000's of people without a GP (~1/6)

+ a mountain of evidence that incentive fees will NOT fix that problem.

🤞that we will get the structural change we need

e.g. funding for non-profit CHC's (evidence this works!) policynote.ca/chcs-in-bc/

How could federal support of primary care access help??

1) Infrastructure funding... what if health clinic buildings could be funded by federal $?
2) Transparent enforcement of the Canada Health Act, require access to all the services that we need (e.g. rural maternity services)

I am happy that primary care is a federal election issue. We have so much great research to inform what STRUCTURES are needed.

Let's use it!
#BCPrimaryCare

There are some excellent ideas about what needs to happen for true reform.

For example, by @picardonhealth

And @docdanielle’s book introduces 6 important ideas to use as a framework for healthcare redesign.

To say nothing of the recommendations made in the Romanow Report

en.m.wikipedia.org/wiki/Royal_Com…

We do not lack good ideas.

We need coordination and implementation. And, transparent and robust evaluation.

Talking to @Adam_Stirling on @cfax1070 about #BCPrimaryCare

Teams versus solo doctors, could be an answer to reducing fragmented, episodic care.