Len Frank, Executive Director
Leduc Beaumont Devon Primary Care Network
Candra Tinis, Communications Coordinator
Leduc Beaumont Devon Primary Care Network
Who is your family doctor?
The next time you visit your family doctor’s office, you will probably be asked to name your family doctor. This simple question will start to change how family medicine (primary care) is delivered in the province. This question can also save our health system millions of dollars, improve health results for patients, and improve both patient and physician satisfaction.
The importance of having a family doctor
Building and keeping a trusted relationship with your family doctor means that he or she understands your health background and issues you may experience. A family doctor can direct you through the healthcare system better than if you did not have a family doctor or if you receive care from more than one doctor. People who have a family doctor visit the emergency room less often and when they do use this service, the length of their stay is shorter than for those who do not have a family doctor. This saves the healthcare system money and time.
Research shows that patients have better health results, less illness and live longer if they are under the care of a regular family doctor. This is called continuity. Strong, trusting, patient-physician relationships also lead to higher levels of satisfaction with the healthcare system. There is also less chance of error when there is one doctor prescribing medicine.
Being under the regular care of a specific family doctor is limited by their availability and patient choice. No individual doctor can provide all aspects of primary care at all times and some patients choose not to have continuity with one doctor. As a result, care becomes distributed across a group of doctors and other providers who are not connected to each other. This is known as discontinuity.
There are solutions to discontinuity that maintains a high level of patient care. When a patient can’t see his/her usual doctor, the best thing a patient can do is to see another doctor who works closely with the regular doctor, for example, another doctor in the same clinic. The next best option after that is seeing a doctor who has access to the same medical record as their regular doctor. Currently, this is a challenge in Alberta because the majority of electronic medical records used by family doctors are not connected to one another. At the Leduc After-Hours Clinic we address this issue by sending patient records to the every patient’s family doctor. The least effective option is for the patient to see another doctor who has no connection to their regular doctor. This option is linked to higher health system costs and poorer health outcomes for patients. Therefore, it is not only important to maximize continuity but to manage discontinuity as well.
Reducing the chance of discontinuity is an important goal of our primary care system and it can be accomplished through teamwork. The stronger the teamwork between the patient’s providers, the better the result. Patients who are attached to a family doctor are more likely to receive consistent care such as scheduled tests and screenings and access to programs and services in their local Primary Care Network (PCN). PCNs have other healthcare providers such as nurses, dietitians, pharmacists, exercise specialists and mental health clinicians who work together with the family doctor to provide care to the patient. Primary care systems should be structured to encourage continuity to both individual doctors and teams of healthcare providers.
Timely access to your family doctor
Lack of timely access to care is often a major issue that affects patients. How quickly patients can get in to see their family doctor and the doctor’s team of healthcare providers is a very important piece to continuity. Poor access will result in discontinuity because patients are forced to find care somewhere else such as a walk-in clinic or emergency room. If patients can’t be seen in a timely manner, continuity is broken and the benefits to having a family doctor are lost.
Access is complicated and impacted by many factors including:
• The number of patients that a doctor cares for (also called a “patient panel”): Doctors with large patient panels have less time to care for their patients and patients will find it harder to get into see them.
• Extra clinic responsibilities: Most doctors in Leduc have clinical responsibilities outside of the clinic. This may include in-patient care, working in the emergency room, visiting patients residing in long term care, working the after-hours clinic and attending meetings with the PCN and Alberta Health Services.
• The amount of time that a doctor works in the clinic: Doctors are like everyone else. They have responsibilities in their personal lives that impact how often they work in their clinic such as child care issues, getting sick, etc.
Continuity of care and access are closely connected and the best primary care system focuses on both. Our primary care system has to improve on both in order to achieve our goals. These goals include better care, at the right place, lower overall health system costs and improved satisfaction for both patients and providers.
So what are we at the PCN trying to do about it?
Access and continuity are a major focus for all PCN’s in Alberta. With the support of Alberta Health and the Alberta Medical Association, PCN’s across the province are working to address these issues in a province-wide initiative called ‘PCN Evolution’. To date, our local PCN has done the following:
• Established a baseline for access: In the spring of 2014, the PCN conducted a patient satisfaction survey and asked patients who attended their family doctor’s office, “How long did you wait between making this appointment and your visit today?” In November of 2014, all member doctor clinics started reporting on timely access to evaluate how long patients have to wait, on average, to get an appointment.
• Started to develop patient panels: Beginning in November 2014 – all member doctors started confirming who a patient’s family doctor is. This helps doctors to develop confirmed lists of who their patients are and it allows doctors to better manage their patients care.
• Provided access to resources to help clinics improve timely access to care and manage patient panels: These resources include Toward Optimized Practice and Alberta Access Improvement Measures (AIM). These programs are provided by the Alberta Medical Association, Alberta Health Services, Alberta Health and other groups.
• Worked to recruit more doctors to our area: The number of doctors accepting patients in our area is at an all-time low and the PCN is working to recruit doctors to the area. This will help improve access to primary care doctors for patients who do not currently have a family doctor and would like one.
Making changes while of running busy practices and providing quality patient care is not easy. There are no easy/quick fixes and these issues will take time (years) to address. But we are well on our way.
What can you do?
• Call your family doctor first – don’t assume that you can’t get in to see your doctor. Even if your family doctor isn’t available, it’s possible that another doctor in the clinic will be available to see you. This doctor would have access to your medical history and current treatment.
• Please tell your doctor if you have a hard time getting in to see them. They want to know if limited access is a problem for you.
• If you book an appointment to see your doctor and then are unable to attend, call the office as soon as you can. Many patients either just don’t go to their appointment (no-show) or they call with very little notice and the appointment can’t be filled by another patient (late notice cancellation). This is a big issue in our PCN. Every month, almost 530 appointments are lost due to no-shows and late notice cancellations. This equals 6400 appointments lost per year! This is almost equivalent to the number of patient appointments that a full-time doctor provides in an entire year. At a time where many people can’t find a family doctor, imagine a doctor sitting at their desk without seeing a single patient for an entire year due to this problem.
How to connect with a family doctor – Leduc, Beaumont, Devon
As part of our continued commitment to patients in the City of Leduc, Towns of Beaumont, Devon and Calmar, Leduc County and its communities and in response to the growing need for patients to be connected to a family physician, the PCN maintains an up-to-date list on its website of all of its member physicians that are accepting new patients. Please visit www.lbdpcn.com for that list.
The PCN also provides services to those without a family doctor through the Leduc and Beaumont After-Hours Clinics and also attaches long term care patients who do not have a family doctor.
How to connect with a family doctor – Edmonton and area
In 2012, the Edmonton-area PCNs worked together to develop the Find a PCN Family Doctor website that provides the public with an up-to-date list of PCN member physicians in the region who are accepting new patients. As of December 1, 2015, there are over 250 Edmonton-area PCN family doctors accepting new patients.
The user-friendly website, www.edmontonareadocs.ca, is updated every three months. PCN doctors can be searched by the Edmonton and area map, gender, location and language.
This article was printed in the Devon Dispatch on January 8, 2016 and in the Leduc Representative on January 15, 2016.