I became a family doctor because providing comprehensive, compassionate care gave me meaning. In the small community I served in Twillingate, N.L., I have watched infants I cared for grow up and I’ve watched people reach the end of their lives. I am a part of this community and the relationships I’ve developed are central to what it is to be a family doctor.
I know that my patients also value these relationships. They know I see them as a person and not just as a collection of ailments to treat. I am able to offer treatment plans or advise healthier lifestyles based on what I know about my patients’ socioeconomic situation and their family environment — right down to knowing whether they are likely to follow my advice.
Family medicine is rewarding and complex, more so now than ever before. However, it is becoming more challenging to address this complexity using traditional practice organization.
For example, a patient who is dealing with a chronic condition while managing a series of medications and coping with family issues needs support from a community-based team of health professionals to effectively take care of their health. To address this complexity, improve service and meet the evolving needs of patients, provinces are experimenting with a variety of primary care models.
The College of Family Physicians of Canada launched its vision of the future of family practice in 2011. It’s called the Patient’s Medical Home (PMH) and the model has caught the attention of provincial decision-makers and health-care providers across Canada.
PMH is best described as a family practice serving as a central hub for providing care that is responsive to the needs of individual patients and their communities.
The model embraces health information technology, which includes electronic records to store and share information across points of care, allowing health professionals to communicate efficiently.
Evidence shows that PMH models of family practice lead to better care, better outcomes, lower health-care costs and increased satisfaction for providers and patients. When the model works well, it is associated with reduced reliance on emergency rooms, better adherence to treatment plans, better access to after-hours care and improved patient follow-up.
Recognizing the variability of health care delivery across Canada, the PMH is not based on mandatory criteria, rather it is a set of pillars that supports the need to be responsive to communities. The further a practice is aligned with the PMH vision, the better it can deliver on the full potential of the model.
To realize the vision of better care and better outcomes for all, the PMH needs support from provinces, territories, the federal government, decision-makers, health-care providers and the public, who will ultimately benefit from the model’s results.
With government support and joint participation from the health professionals who make it possible, the PMH can deliver care that is accessible and responsive to the needs of Canadians. The progress made in the past seven years is impressive, but more work is before us.
What I have valued most as a family doctor in Twillingate has been working with a good team with the common goal of improving people’s lives through better access to person-centred care.
The Patient’s Medical Home vision can make this achievable and accessible for everyone in Canada.
Senator Mohamed-Iqbal Ravalia is a former family physician. He represents Newfoundland and Labrador in the Senate.
This article was published in the November 14, 2018 edition of The Hill Times.