Dear Colleagues,
I wanted to share with you the input we provided to the OMA/Ministry of Health Primary Care Working Group, chaired by Drs. Nadia Alam and David Price. We were asked to submit our thoughts by July 15 on Access and Quality, Complexity Modifiers, Walk-In Clinics and GP Focused Practice Designation. I received input from members and shared this with our Committee that was comprised of Directors from our Board. The group represented of a mix of practice models, including two FFS family doctors, an academic FHO/FHT and a community FHO/FHT.
The OCFP’s submission reflects our “north star” – that ideal patient-centred primary care is delivered within the context of a Patient’s Medical Home (PMH) and Patient’s Medical Neighbourhood. This international evidence-based vision is payment model agnostic.
Nonetheless, the pandemic has laid bare further inequities among practice models and in the ability of family physicians to respond to needed care in our communities. We have repeatedly emphasized this lack of equity, which in turn affects patient care and the viability of many family practices. Family physicians should have choice in their payment model and all deserve access to team-based care.
The SGFP and the OMA are holding a Town Hall on July 23 and our Committee will be attending, prepared to expand on our submission as needed. You will have received Dr. Aly Abdullah’s (Chair of SGFP) email of July 18, with links for both the registration for the Town Hall and for input to the Negotiations Committee, among other upcoming events relevant to family physicians.
Our full submission is posted on the OCFP website. The four areas of requested feedback are interconnected - solutions must be comprehensive and sustainable and not mere tweaks at the edges. Here are the highlights:
Access and Quality
- Team-based care will help family physicians manage their more complex patients, and must be available to all practices.
- Virtual health care – Enables increased access but platforms need to be improved and billing codes need to be more nuanced.
- Open access to capitation models for family physicians who wish them, with harmonization to provide equity in the ability to deliver comprehensive care and thrive in practice.
- Access – Use better measures for access than “same or next day” availability; Improve three-way accountability measures for better access including physicians, government and patients working together.
- Population-based system integration – EMRs that are interconnected with hospitals and home and community care, and leading towards a provincial Electronic Health Record and shared data platform; Better family physician connection to home and community care; Integrated and more streamlined referral system.
- Family Physician Leadership in Design and Delivery – Support is required for clinical leadership and organizing primary care.
- Quality Improvement requires practice facilitation and administrative supports.
Complexity Modifiers
- Restore the previously established interim payment methodology acuity modifier and apply across all models.
Walk-in Clinics
- Connect walk-in clinics to local family physicians in a seamless fashion; Explore drivers of walk-in clinic use as they can reflect problems with access and accountability.
GP Focused Practice Designation
- Should uphold the principles of the CFPC Family Medicine Professional Profile (augmented skills fill a community need).
We have also been asked to provide input directly to the Negotiations Committee and much of the above will inform that input. We are working together with our SGFP colleagues to align priorities. Together our voices will improve access to the high quality of care that our patients need and foster greater equity and support among those of us who serve them.
On a COVID-related note: we may have some positive developments to share about PPE early next week. I will be communicating with you again when further details are known.
As always, I value the input provided by my family physician colleagues. Thank you for being part of the Ontario College of Family Physicians. Your voice makes us stronger.
Jennifer