Dear Colleagues,

 Important updates to share with you.

 Patient reluctance to seek care. Our patients need to know that we are keeping them safe – in our offices, in the ER, and in all settings where we are providing care.

 Over concerns about virus transmission, many patients are forgoing needed care – whether for a healthcare matter that pops up unexpectedly, a chronic condition that requires ongoing care, or for well-child visits and immunizations. They need to know that we are available and want to hear from them, including seeing them in person when you have determined it is warranted and safe to do so. Stay tuned to the OCFP on Twitter (@OntarioCollege) next week for more on this topic.

 In addition, stories from our Emergency Rooms are emerging of patients presenting later in their disease process, for fear of going to the hospital. Emergency Rooms are doing their very best to protect patients, separating suspecting COVID illness from non-COVID illness. If a patient needs to go the Emergency Room, they should be encouraged to do so. 

 Changing the Way We Work - Community of Practice. Hosted by the OCFP and UofT Department of Family and Community Medicine, and moderated by Dr. Tara Kiran, this Community of Practice is by and for family physicians. Join us on Friday May 1 from 8 - 9 a.m. ET for the next session. Hear from Dr. Nadine Laraya (Toronto), Dr. Daniel Pepe (London) and Dr. Arieg Badawi (Milton) about how they are supporting their colleagues and communities.

 COVID-19: Clinical and Practical Guidance for Primary Care Providers. The OCFP is collaborating with the Centre for Effective Practice (CEP) on tools and resources for family physicians. During this critical time, the CEP is actively updating its COVID-19: Clinical and Practical Guidance for Primary Care Providers - a single resource that tangibly interprets the latest guidance, advice and evidence to support family physician decision-making. Family physicians are encouraged to suggest potential topics.

 Among the topics is a section on mental health and well-being for providers that includes guidance and links to more than 20 resources for resilience, self-care and psycho-social supports for physicians, including Canadian Psychological Association members who are volunteering to provide psychological services to front line healthcare providers.

 Membership fees. The OCFP and CFPC want to acknowledge the significant personal and professional circumstances facing you, our members, and the medical profession as a whole. On April 17, the CFPC replied to a letter from Ontario Medical Association, outlining how we are supporting members facing financial stress. These are uncertain times, and we must stand together in advocating for what is needed to best care for our patients.

 Safe transfers to retirement homes. According to Ontario Health, the Ministry of Health and Ministry for Seniors and Accessibility, hospitals may now resume discharging patients to retirement homes, provided: the receiving home is not in a COVID-19 outbreak; the patient has been tested for COVID-19 at the point of discharge and is determined to have a negative result; the patient being transferred completes 14 days of self-isolation upon arriving at the home; and the home has a plan to ensure this occurs.  

 Death certificates in long-term care. All long-term care deaths will be certified by the coroner and paperwork will be filled out by the staff. For those of you working in long-term care, you may be asked to provide additional information to inform the death certificate.  

 Death certificates at home. Attending a death in person is a role that many of us value, and this remains your choice to do so. Please pronounce using appropriate PPE and before the body is moved. Another health professional (EMS, nurse, police) may make the pronouncement and the family physician can deliver the death certificate, without having seen the body, within 24 hours to the funeral home in person, by email or fax. See the Ontario Palliative Care Network's new Managing Expected Death in the Home During COVID-19 guidance document.

 OCFP Website. We continue to update our website to make the COVID-19 resources we have shared over the weeks easily accessible. Please let us know if there are other issues that the OCFP should address, and we will do our best!

Share your pandemic experience. To inform advocacy efforts in support of family doctors, take this short, confidential survey (three minutes to complete) about the impact of COVID-19 on family practices across Canada. The survey is part of the Strategy for Patient Oriented Research (SPOR) Primary and Integrated Health Care Innovation Network, in partnership with the Larry A. Green Center, and will close on Monday April 27 at 11:59 p.m. PST. You can access results of previous surveys on the survey page.

With much respect for what you do in your offices and your communities,

Jennifer