Ontario’s Minister of Health is promising that people will soon have more timely access to their family physicians. The province’s 200 family health teams will come under the control of Ontario’s 14 local health integration networks (LHINs), the regional authorities that currently oversee the system. The goal is to give citizens speedier access to primary care, and it is assumed that these changes mean that people will make rational choices; in particular that they will not go to an emergency room if a visit to a family doctor can be arranged.
I am in awe of this assumption on several fronts. Some residents of Ontario still do not have the luxury of a family physician. It seems unlikely that the limited supply of doctors will automatically grow just because LHINs will be responsible for family health teams. It also seems unlikely that this will mean patients who do have family doctors will suddenly be able to get same-day appointments.
I believe we currently spend more than enough on health care, but it is not properly deployed and not provided in a seamless manner. Scope of practice concerns often keep nurses and therapists and other care providers from working to their full potential. When will we make courageous and bold decisions to address how health care teams work together and make sensible choices about who can provide care and when? Frequently I don’t need to see a physician and could function well with a nurse practitioner who could perform wellness consultation and prescription renewal. At least I think I could function well, and I would certainly be happy to try.
Deb Matthews’s website mentions that Ontario is moving forward with 25 nurse practitioner-led clinics across the province. That might be an answer. This is an admirable step and needs to be followed up quickly by many more.
We need to totally reset the expectations of care providers and recipients. The people of Ontario have not designed the system that they now struggle to access; rather it has grown up around them. It is time to eliminate barriers to sharing resources and to deploying them in a manner that will provide the results that are required. Merely tinkering with the system in its current form will not utilize the knowledge, talents and abilities of all those who provide health care, nor will it help us to use our money more effectively or efficiently. Until we redesign the delivery service model and the goals and objectives of the Canadian healthcare system, emergency rooms will still be overflowing. Until we start to work toward a common vision for all Canadians, I’ll remain skeptical about the chances of getting a same-day appointment with a family physician.