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Rita McCracken, MD, PhD
@DrRitaMc
, 8 tweets, 6 min read Read on Twitter
@DocVan_Nostrand @MariaMichelleH Putting all the responsibility/money for all the things on family doctors, is not really working out:

❗️clinical care
❗️teaching learners
❗️running office
❗ transforming primary care
❗️Leading quality initiatives
❗️evaluating system change
❗️increasing access & capacity

🤔
@DocVan_Nostrand @MariaMichelleH What is the work that Family Doctors *must* have a leadership role in... ?

And what work could we rely on skilled professionals for?

(Analogy: if I was renovating my house, which bits would I want to be in charge of v. Get advice v. contract out completely)
@DocVan_Nostrand @MariaMichelleH I forgot

❗️cleaning data in your emr
❗️attending evening meetings about new fee codes &how to increase billing’s
❗️order the right amount of flu vaccine
❗️know all the non profit support services to refer your patients too in the lower mainland
❗️store &archive charts forever
@DocVan_Nostrand @MariaMichelleH ❗️read all the journal articles
❗️attend all the conferences
❗️attend all the engagement meetings
❗️complete all the surveys
❗️vote for all the committees
❗️write letters when your emr/excelleris starts sending you 97 versions of results from one lab req

what am I missing?
@DocVan_Nostrand @MariaMichelleH I AM NOT THE ONLY HUMAN WHO CAN DO ALL THESE THINGS.

I WOULD REALLY LIKE TO WORK IN A TEAM WITH SKILLED PROFESSIONALS, SHARING TASKS, WORKING TO SCOPE.

Sorry for yelling.
gif.co/2yNt.gif
@DocVan_Nostrand @MariaMichelleH I thought of some more work that would be more appropriate to share with both doctor and other skilled professionals:
❗️explain gender inequity in medicine
❗️develop systems that support trauma-informed care
❗️catalogue, celebrate &capitalize on community strengths
@DocVan_Nostrand @MariaMichelleH ❗️create structures that welcome and attract diverse voices to leadership
❗️promote science-based celebrations of all body sizes &types
❗️Participate in practice-based research that improves primary care interventions at the patient and system level
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More from @DrRitaMc see all

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Rita McCracken, MD, PhD
@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...
Read 14 tweets
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Rita McCracken, MD, PhD
@DrRitaMc
It would be great if every medication worked 100% of the time, but they don't.

The NNT (Number needed to treat) is a way to quantify how often the medication "works"

(caveat: what a drug "working" means is a whole other tweetorial/PhD dissertation!)
#SafeMedsBC
To help us get our heads around the math of NNT... an analogy...

Imagine kids learning to read.
If you have 20 kids in a grade one class, by the end of the year, you might have 10 kids who can read. By the end of Grade 3, likely almost all will be able to read.

#SafeMedsBC
THE MATH PART:
20 kids x 3y = 60 kids, after 3 years ~60 can read
60 kids/60 readers = NNT of 1, ie every kid that you send to school for Grade 1-3 has a pretty good chance of learning to read (AMAZING!!)
#SafeMedsBC
Read 10 tweets
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Rita McCracken, MD
@DrRitaMc
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
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 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
Read 14 tweets

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