Dear Colleagues, 

It has been a while since we’ve been in touch and as a result my message is longer than usual. So feel free to grab a coffee for this longer read! We have lots of helpful updates to share with you.

I want to start by saying I remain hopeful. I do feel we are making our way out of this pandemic; vaccination rates continue to rise and our COVID numbers are holding steady. At the same time, I know that many are struggling, feeling tired and burned out – I have heard from you. The clinical lift continues to be heavy and it can sometimes feel that we are not making a dent. But know that you are making a difference. The evidence shows time and again that every successful health system is built upon a strong primary care system, and we as Ontario’s family physicians are the backbone of that system. 

Please seek care for yourself as needed. You can check out the OCFP’s upcoming Practising Well Community of Practice sessions where will discuss burnout and balance on October 27, and getting off the path to burnout on November 10 (both from 8-9 a.m.). We are also hosting an info session on November 2 at 7 p.m. on how to become a Peer Guide and support others.

SEEING PATIENTS IN PERSON

• The recent statement from MOH/CPSO/CMOH underlines the importance of in-person care for our patients. In the OCFP’s guide to in person care, we reinforced and encouraged the shift from “Virtual First” to a “Patient Centered” approach given the high vaccination rates and better access to PPE.
• If you continue to struggle with seeing patients in person, we’d like to hear more from you about what supports you may need – please email us at [email protected].
• For ventilation tips, see pages 9-10 of the PHO’s Summary of IPAC Key Principles for Clinical Office Practice, and here are five things to consider in an air quality check from infectious disease specialist Dr. Jeya Nadarajah.
• Ontario Health has developed suggestions for practices on how to navigate care for patients with influenza-like illness. As you will see, navigation is based on office readiness and access to assessment centres.
• Here is a script that can be adapted for your clinic’s patient communications to reinforce the move towards more in-person care.

MEDICAL EXEMPTIONS

• As you know there are very few medical exemptions to vaccinations. See this MOH medical exemption letter you can use for patients.
• Patient-facing messaging on exemptions can be found in this guide from a group of doctors, pharmacists, scientists and patients (other versions of this are available on this website).

CO-ADMINISTRATION OF VACCINES

• NACI has updated guidance on co-administration of vaccines, noting “COVID-19 vaccines may be given at the same time as, or any time before or after, other vaccines, including live, non-live, adjuvanted, and non-adjuvanted vaccines.”
• This should make the COVID/flu shot rollout easier this fall. A reminder that you can reach out to your local PHU/Primary Care contact if you wish to provide COVID vaccination in office.
• Check out the recording and resources from our last Community of Practice session, co-organized with the U of T Department of Family and Community Medicine (DFCM), which focused on the upcoming flu season and flu vaccines (available here).

THIRD DOSES

• Vulnerable elderly living in high-risk congregate settings, and people who are immunocompromised are currently eligible for third doses. See pages 5-8 for a list of the immunosuppressant medications for third doses.
• Guidance for what to do for those vaccinated out of province/out of country is provided here.

MENSTRUATION AND VACCINES

• You likely have heard concerns from patients about changes in menstruation after COVID-19 vaccination. Helpful info for your patients: this Myths and Facts info-sheet from the SOGC and patient-friendly infographic from Unambiguous Science.

FOR YOUR PATIENTS WITH VACCINE QUESTIONS

• Two excellent by-appointment services open by self-referral to all patients across Ontario to answer questions and concerns about COVID-19 vaccines: VaxFacts Clinic from Scarborough Health Network (connects with a team of doctors) and COVID-19 Vaccine Consult Service from SickKids (connects to a team of paediatric registered nurses). VaxFacts currently has a >80% success rate in helping patients to move towards vaccination.

TESTING

• We developed a summary of testing basics for family doctors, including information on available and appropriate tests.
• Here are links to a list of testing and assessment centres and PHO’s testing resources page, with information about specimen collection and ordering test kits.
• Consider providing in-office COVID testing. If you are interested, reach out to your Ontario Health Regional Testing Lead.
• Hear more about testing at our upcoming COVID-19 Community of Practice, co-organized with the University of Toronto DFCM.

HAVE YOUR SAY | OTHER RESOURCES

• A national study is recruiting physicians to understand the impact of tailored and targeted digital communication on vaccine uptake among patients. Those participating will receive patient outreach, survey and feedback services free for one year. Learn more.
• The CPSO is seeking input on their draft Virtual Care policy, which sets out expectations for physicians on when and how to provide appropriate virtual care. Share your thoughts.
• Cancer Care Ontario has developed a comprehensive toolkit available in multiple languages to help you get your patients caught up on cancer screening.
• For managers and front-line workers, the Ontario Psychological Association is hosting Managing Mental Health in the Workplace During COVID-19 on October 19. The OCFP is pleased to partner in this free, one-day virtual event. Learn more/register here.

FROM THE OCFP

• Join us November 10, 5-6 p.m. for the OCFP Awards ceremony as we honour the exceptional contributions of family physicians and celebrate our profession. Trust me, it will lift your spirits to celebrate your colleagues!
• In this Mood Disorders workshop, psychiatrist Dr. José Silveira covers the current evidence and realistic approaches you can apply immediately in your practice.
• Registration for the OCFP’s Family Medicine Summit (FMS) is now open. Participate in more sessions than ever, including live-stream events on January 28-29, 2022, and on-demand sessions that you schedule at your convenience. Learn more/register at ocfpsummit.ca.
• New this year, in an effort to share perspectives and ideas from early-career family physicians, we have reserved space in the agenda and launched a Call for Abstracts open exclusively to family medicine residents and those in their early years of practice. The deadline is October 24, 2021, and selected presenters will get dedicated support to prepare their talk.  

*****

I would like to close with two important announcements about the OCFP. The first is that I am delighted to welcome our new CEO, Kimberly Moran. Kim comes to us with extensive health system leadership experience having been the CEO of the Children’s Mental Health Organization. She will bring her skills in advocacy, communication and policy to our work at the OCFP to help us support you and advance the essential role of family physicians in Ontario. 

We also welcomed five new members to the OCFP Board at our recent Annual Meeting of Members: Drs. Jennifer Bondy, Jocelyn Charles, Taylor Lougheed, Ilan Shahin, and Eric Wong. We look forward to benefiting from their insights in our work to support all of you.  

I remain proud and grateful for your work and hopeful for what lies ahead. I invite you to check out the OCFP’s 2020-2021 Year in Review for a snapshot of our commitment to support you in your vital roles.

Warmly,

Liz