Dear Colleagues,

As noted in my last message, the provincial government recently announced an investment of $30 million for up to 18 new primary care teams. This funding will help build capacity in existing teams, allow for the creation of new teams in communities without access and help bridge the gap in accessing interprofessional primary care for vulnerable, marginalized and unattached patients. Expressions of interest will be due at the end of April – more details to follow. 

This is a positive step, but we know much more is needed to ensure equitable access to teams. The OCFP will continue to work collaboratively with the Ontario government to bring needed solutions to the table for all family doctors.

Below, you’ll find more information, tools and resources to support your practice. 

In This Email:

• Long COVID | COVID-19 | COVID-19 Vaccines
• Mpox
• Lyme Disease
• From the OCFP
• Tools For Your Practice
• Other Opportunities
• Advocacy In Action

Long COVID | COVID-19 | COVID-19 Vaccines

• Postural orthostatic tachycardia syndrome (POTS) is associated with Long COVID and can have debilitating effects on patients. The OCFP has developed this summary of information for diagnosing and treating POTS, including steps for the 10-minute standing test, and here is additional information in this BMJ Practice Pointer (Feb. 24) – Orthostatic tachycardia after COVID-19. 
• A virtual program for Long COVID patients is now available from Providence Healthcare. The program includes online educational meetings led by members of an interdisciplinary team, follow-up care and a tailored rehab plan. Get more information and refer eligible patients using this referral form. 
• A reminder that applying the OHIP diagnostic code for treating patients with Long COVID (081) as appropriate is helpful in identifying and tracking health services delivery. 
• Here are helpful Q&As from our February 24 community of practice on Long COVID with U of T DFCM, and some additional tools shared in the presentations:
  1. Ontario Health guidance for primary care (December 2022) for the assessment and management of Long COVID
  2. A one-page summary, guidelines and checklists to assist you in completing income support applications on behalf of patients, including for the Ontario Disability Support Program (ODSP).
• New guidance from NACI (March 3) recommends an additional spring booster be offered to those who are at risk of severe illness from COVID-19 infection and haven't had a shot in six months, including: 
  1. Adults 80 years of age and older.
  2. Adults 65 to 79 years of age, particularly if they do not have a known history of COVID-19 infection. 
  3. Adult residents of long-term care homes and other congregate living settings for seniors or those with complex medical care needs. 
  4. Adults 18 years of age and older who are moderately to severely immunocompromised due to an underlying condition or treatment.
• The Ministry has updated an earlier notice to indicate there will no longer be an interruption in the supply of Moderna COVID-19 vaccine for children 6 months to under 5 years old.
• New resources from the OCFP to share with your patients include a set of tips for teens and adults with colds, the flu or COVID-19 and information on Long COVID.

Mpox

• There have been new cases of Mpox reported in Ontario since January with no clear epidemiological link. The Ministry of Health is sharing updated information for clinicians (March 10), given suspected transmission of mild and subclinical infections. Additional tools and resources:
  1. Recommendations for Case and Contact Management (February 2023)
  2. Vaccine Information Sheet (December 2022) 

Lyme Disease

• As of April 1, Public Health Ontario will use a modified two-tiered testing approach for Lyme disease, designed to reduce the chance of false negatives and improve turnaround times for testing. The new test information sheet and investigation toolkit will be available on the PHO website at that time. Clinical guidance for managing tick bites and investigating Lyme disease is being updated and will be available later this month on the Ontario Health (HQO) website. 

From the OCFP 

• If you are an OCFP member and practising family physician or resident in Ontario and have not completed our survey yet, later today you will receive an email reminder with your survey link. Please complete the survey by March 23 to tell us about the impact of the administrative burden on you and your practice. If you have not received the survey, please check your spam folder and contact us at [email protected] with any questions. We value your input!
• The OCFP is seeking two new non-physician board members. If you know of someone who might be interested, they may apply by March 24. Learn more. 
• Nominations for the 2023 OCFP Awards are open until March 26. Check out the categories and nominate a colleague.
• Register now for our next mental health, addictions and chronic pain community of practice, taking place on March 22, "Mindful Medicine: Adapting and Learning to Cope with Uncertainty." Earn MainPro+ credits by reviewing past Practising Well sessions.
• Register for "Clinical Application for the Long-Term Care Fracture Prevention Recommendations for Frail Older Adults", taking place on March 31.
• Join your colleagues and a Peer Guide in small group discussion to have a conversation about how to better support your patients who have experienced trauma. Space is limited. Confirm participation by completing this short survey.
• Join our upcoming COVID-19 community of practice, "Changing The Way We Work", with U of T DFCM, March 24 at 8:00 a.m. We will discuss COVID-19 epidemiology, boosters and IPAC measures in primary care settings and share some practical tips on how to leverage digital tools to help reduce administrative burden. Joining us are Dr. Chandi Chandrasena and Dr. Michelle Science. 

Tools For Your Practice

• A reminder to register before March 31 to access drug information through your OntarioMD-certified EMR from the provincial Digital Health Drug Repository. 
• Review a catalogue of digital tools and resources from the eHealth Centre of Excellence.
• Ontario Health has released a new quality standard for eating disorders. A reminder that family physicians can obtain MainPro+ credits by reviewing these standards.
• The Ministry of Health is reminding health care providers to include measles in their differential diagnoses, particularly in returning travellers with respiratory symptoms.
• The Northern Primary Care Network has launched NOPCN.ca with resources, tools, data and a password-protected chat room.

Other Opportunities

• The CFPC is collaborating with CIHR for their Health System Impact Fellowship (HSIF) opportunity for PhD trainees, postdoctoral researchers and early career researchers in health services and policy research/related fields.
• A reminder to inform your patients over 80 years of age that virtual appointments with ServiceOntario customer service representatives are available for health card renewal.
• Ontario Health is looking for senior clinical and administrative system leaders to join the provincial Mental Health and Addictions Oversight Table. Submissions should be sent to [email protected] by March 24.
• Join U of T DFCM for a conversation with Dr. Kwame McKenzie, CEO of Wellesley Institute and Professor of Psychiatry at U of T, on how family doctors and primary care providers can better link their work in education, research and quality improvement to the social determinants of health.

Advocacy In Action

• The OCFP continues to advocate on behalf of family physicians. Recent media interviews by OCFP Board Directors:
  1. Dr. Jennifer Bondy: Surge in Windsor-Essex residents without family doctor reinforces calls for health teams.
  2. Dr. Eric Wong: Need a family doctor? So do 65,000 others in the London area.
  3. Dr. Jobin Varughese: Wait times at Ontario walk-in clinics increase in 2022 as more residents go without a family physician.

Thank you to all of you who contribute to OCFP work through education, advocacy and governance. Your efforts are making a difference. I wish you all a happy spring, and I look forward to some warmer days ahead.

Mekalai