"As health advocates, family physicians responsibly use their expertise and influence to advance the health and well-being of individual patients, communities, and populations."

- CanMEDS FM

Family physicians advocate for their patients and their needs every day - from timely referrals, better access to resources, to ensuring coordination of care in the home. Many family physicians also advocate for change at the community and system level - for things like better housing for patients, a national pharmacare strategy, or access to mental health and addictions resources, among other pressing health-care issues.

The OCFP in turn, uses its voice as an advocate on your behalf. Advocating is not a new role for the OCFP and its family physician leaders who have championed change and influenced policy over decades. This has been particularly true over the past months and weeks as the Ministry of Health and Long-Term Care has been reimagining a health-care system that will address timely access and health equity for all Ontarians through the introduction of legislation under Patients First.

As the legislation to support Patients First (Bill 210) is being reintroduced soon, it is an important time to remind members about the key priorities the OCFP has been advocating for over the last while:

1. Effective primary care planning must ensure meaningful engagement of family physicians in order for you to continue to provide high-quality care for your patients.
2. Better integration of mental health and care coordination resources, and an increase in support and resources are required to help family physicians meet patient needs.
3. Planning at the sub-region level across LHINs needs to be undertaken in a way that is supportive of family physicians and their work, and does not create unnecessary bureaucracy, nor feel punitive.
4. Acknowledging the importance of truly seeing primary care as the "heart of the system" around which secondary and tertiary level services need to be planned in a way that allows more appropriate and timely access to specialty and hospital-based care.

Effective advocacy is accomplished by building relationships, acknowledging context and providing solutions. At its best, advocacy seeks to remove barriers for patients and their health-care providers, minimizes conflict, and is forward looking. Importantly, good advocacy is delivered through consistency and clarity of message.

How is the OCFP advocating for you?

The OCFP advocates in a number of different ways, including meeting with government officials - elected and non-elected and working with central agencies such as Cancer Care Ontario and Health Quality Ontario, to ensure family physicians are at the table to inform central planning initiatives that impact family medicine and primary care. In addition, we support you as OCFP family physician representatives, to provide expertise around key policy issues such as Medical Assistance in Dying (MAID), the provincial mental health and addictions advisory committee and low risk maternal-newborn care. We try to lift up your voice and enable family physicians to be supported to participate in local planning efforts.

Key highlights of the OCFP's advocacy

• The OCFP provides members with policy updates through this email - the Pulse on Family Medicine. Since it was launched in early 2015, there have been 13 updates on important topics such as the New Graduate Entry Program, unilateral cuts and funding changes, Patients First, and MAID, among others.
• We have advocated to the Minister of Health and Premier's office about the need for a vision to anchor primary care transformation. Features of this patient-centred vision move beyond simply "enrolment and access" to include continuity of care, coordination, comprehensiveness, equity, and quality improvement and safety.
• We have delivered consistent messages through Pulse communications and advocacy to the Ministry of Health and Long-Term Care about the need to support more equitable access to inter-professional health-care providers, particularly to support family physicians caring for patients dealing with mental health and addiction issues. This also includes joint statements to the MOHLTC from the Ontario Primary Care Council about the necessity for care coordination to be embedded in primary care settings with resources that will support continuity and comprehensiveness. In Local Health Integration Network (LHIN) engagement sessions earlier this year, family physicians overwhelmingly spoke about the need to access social workers and reduce referral wait times for psychiatry, and we have amplified this message to the Ontario government.
• We have written letters from the President of the Board of Directors and CEO to the Minister of Health and Long-Term Care and Deputy Minister about Bill 210 concerns, and responded to the Patients First proposal. The OCFP will review the Bill, continue to advocate and monitor the Bill as it progresses through its legislative journey. The OCFP will provide an update about Bill 210 to members through another Pulse.
• We have hosted the "Members' Forum" at the Annual Scientific Assemblies with MOHLTC leaders to present information and answer questions from family physicians.
• We have responded to policy issues such as RN Prescribing and some of the unintended consequences, participated in planning for the resettlement of Syrian refugees, and articulated the need to support family physicians to take on clinical leadership roles.

Advocacy takes time and the results are often not readily apparent. What is important is that the OCFP continues to reinforce the important role that family physicians play in delivering high quality care. It is most productive to be at the table to provide context and offer solutions, and together, to work through the challenges facing family medicine and primary care, and the health system in Ontario. Collaboration among family physicians with the expertise of their colleagues - specialists, nurse practitioners and registered nurses, pharmacists, and other inter-professional health-care providers - will enable partnerships that put patients and their families at the centre of care.

By unequivocally maintaining this focus - putting patients at the centre of care as you do every day - and by being good stewards of our health-care resources, family physicians will contribute to system reform that will create a more responsive, accessible, and sustainable system of health care in Ontario.

Links and Resources

• OCFP Letter to Minister Hoskins about Bill 210 - June 10, 2016
• OCFP Response to Patients First - Feb. 29, 2016
• A Proposal for the Future of Health Care in Ontario and a Role for Clinical Leadership - December 17, 2015
• New Graduate Entry Program: More Questions than Answers? - October 28, 2015
• Patient's Medical Home
• Medically-Assisted Dying Information and Resources
• Refugee Resettlement Information and Resources