family physician @UnityHealthTO, Fidani Chair in Improvement & Innovation @UofTFamilyMed, Scientist @MAP_Health @ICESOntario, mom of 3, tweets are my own
Jun 10 • 12 tweets • 3 min read
Fun fact: nearly every person in Denmark 🇩🇰 has the name of their GP (or group of GPs) on their healthcard
It's an organized system where 98+% have access to primary care.
How do they do it? One key lies in how GPs are organized. 🧵
(photos of Christian Folsach's practice)
GPs in Denmark are small business owners, similar to family doctors in Canada. They rent or own the office space, hire staff who work in the office, and pay for everything from internet to paper. Most practices in Denmark are small with b/w 1 to 3 GPs working together.
Jun 3 • 12 tweets • 3 min read
How is that >98% of Danes have a GP? Part of the answer lies in their approach to training physicians.
Here's a summary of some of what I've learned on my trip to Denmark 🇩🇰 🧵
(the photo here is a wall of some of the 170+ residents trained at the practice I visited)
After high school, most Danes take a gap year where they typically work and travel (the average is 2 gap years but several take even more). They would then apply and gain admission to medical school which is 6 years in total.
Oct 16, 2023 • 9 tweets • 4 min read
Today we concluded the #OurCare Manitoba Priority Panel, our 5th & final reference panel on primary care in Canada
30 members of the public, randomly selected, spent >30 hrs since the start of Sept, learning, deliberating & coming to consensus on recommendations for better 🧵
These members of the public, roughly represented the demographics of the province — with one exception. We deliberately overrepresented people who identified as First Nations, Métis or Inuit.
Apr 28, 2023 • 25 tweets • 10 min read
In 2021, family docs were being blamed for seeing too many patients virtually, purportedly causing more people to visit the ED
w/ @RickGlazier1@DrMichaelGreen1 jamanetwork.com/journals/jaman…
Let's start by going back to fall 2021. Most people had been vaccinated and we thought we were heading out of the pandemic. We were starting to try and clear the backlog of care.
EDs were overcrowded and some people blamed it on family docs.
Apr 4, 2023 • 24 tweets • 10 min read
Primary care is in crisis. How can we do better?
We brought Ontarians into a room and asked them.
Today we release their final report.
35 volunteers, randomly selected
39 hrs of learning & deliberation
23 recommendations for better🧵
#OurCare
https://t.co/1aXw6oLCP5ourcare.ca/s/OurCare-ON-P…
We were blown away by interest in this process
1250+ people volunteered to be part of the panel!
From those, we randomly selected 36 to roughly represent the demographics of Ontario, over-representing equity-deserving groups
(ultimately 1 wasn't able to participate)
Feb 12, 2023 • 7 tweets • 6 min read
Today we’ll hear the draft recommendations from a group of 36 everyday Ontarians about how to make the #primarycare system better
They were randomly selected from 1250 who volunteered
They’ve spent 40+ hrs learning from experts and each other
What’s been in the curriculum?
We started virtually with talks from
rebrand.ly/3rd-dose 🧵
The number of doses you need depends on
-your age
-whether you have a weak immune system and
-whether you live in a setting were you have a higher risk of getting COVID
Here we've summarized recommendations for people who do NOT have a weak immune system 👇🏽
Apr 7, 2022 • 18 tweets • 4 min read
Why have so few Ontarians received Paxlovid, a drug that can reduce the risk of hospitalization for those at higher risk of #covid?
Here are some of my observations as a family doc 🧵
To start, there has been too little public communication about treatments available, who qualifies & where they can access it
We’ve tried to fill this gap with resources like this one
Most people who become infected with COVID can recover at home without any treatment
But there are now medications doctors can prescribe to keep high-risk folks from getting seriously ill
Which meds? Who can get them? We break it down in our latest @ ConfusedAboutCOVID.ca
To start, all these meds are meant for people who are at high risk of getting seriously ill from COVID
That's b/c of the limited supply but also b/c the research studies were done in these groups.
Who qualifies? Call your doctor if any of the below applies 👇🏽👇🏽👇🏽
Jan 26, 2022 • 7 tweets • 7 min read
You just found out your child has COVID. What should you do?
How can you best care for your child? When should you call the doctor or take them to the ED?
*NEW* Our latest study @AnnFamMed@RickGlazier1 shows that team-based primary care, coupled with payment reform, can improve patient outcomes & reduce ED use
We desperately need to expand team-based primary care in Canada
(a mega 🧵) #Primarycare is the foundation of a high-performing health system. Yet, primary care has been in crisis for the last 2 decades—challenged by an outdated payment model, growing patient need, rapidly growing evidence, and dysfunctional electronic medical record systems
Jan 22, 2022 • 10 tweets • 4 min read
Thanks to the 1000's of people who have powered our 3rd dose effort. We've made amazing progress in a short time—and still have further to go.
A thread on why 3+ doses continues to be important and where we need to focus 🧵
We now have more real world data showing that 3 doses is better than 2 at preventing infection and serious illness with Omicron
These two slides were shared by Dr. Allison McGeer and summarize data on infection and hospitalization with 3 v 2 doses in the UK
I know some parents are reasonably worried about the risk of myocarditis following COVID-19 vaccination for children 5 to 11
Here's what we know about the risk and why experts think it will be much LOWER in this age group than with teens/adults 🧵
First, it seems that kids have a lower predisposition for myocarditis and pericarditis.
Ontario data show the natural incidence of myocarditis and pericarditis (pre-COVID) was much lower for those <12
Like many parents, I'm struggling to understand why the Ontario government is so strongly against using rapid testing to prevent the spread of #covid in schools.
THREAD 🧵
Is it because the tests are in low supply or too expensive to purchase?
No. My understanding is the feds are purchasing and distributing the rapid tests to provinces
Sep 29, 2021 • 8 tweets • 3 min read
Let’s prevent a junior-edition of the vaccine “hunger games”
Instead, let take a schools-based approach so every child age 5-11 has a chance at getting the #covidvaccine once approved
I want to start by acknowledging the confusion and frustration that the latest NACI statement has caused those who got the AZ vaccine—and the pharmacists and primary care clinicians supporting them
As I write, I know many are on the phone rescheduling appts
A few thoughts 🧵1/
NACI has said that an mRNA vaccine is preferred as the 2nd dose for those who received AZ for their 1st
They also reassure folks who got AZx2 that they have very good protection against severe death and hospitalization 2/