Opinion

Despite what you might think mid-pandemic, family medicine is more necessary than ever

A dangerous misconception has taken hold as the COVID-19 pandemic rages on, and it must be refuted – despite the noise, family physicians’ offices are in fact open.

The false assertion that they are closed, when 95 per cent of family physician offices across Ontario actually are providing some form of care, risks patient safety as they avoid seeking necessary care, thereby delaying timely diagnoses and increasing downstream comorbidities from preventable diseases, adding unnecessary burdens on already taxed hospital emergency rooms.

Primary care is the foundation of strong health-care systems internationally and supporting the efforts of our primary care workforce is essential to maintaining positive health outcomes and health equity

The pandemic has added new challenges for family physicians, who represent a diverse workforce. They have rapidly shifted from in-person visits to virtual primary care, helping to mitigate pandemic restrictions, particularly for vulnerable populations such as people over 65; staffed COVID-19 assessment centres; adapted to new technologies and workflows; and modified existing schedules to see prenatal and pediatric patients in person. Primary care organizations across Ontario have collaborated to offer to take on vaccine distribution given their intimate knowledge of barriers and hesitancy in patients and their ability to reach vulnerable populations based on relationships and continuity of care.

As our communities begin to reopen and screening rates for cancer and preventable non-communicable diseases return to pre-pandemic rates, family physicians will be the first to face the inevitable onslaught of increased chronic disease burden and establish comprehensive management plans for months and likely years to come. 

Thus, it is essential that we encourage our medical students to meet the coming challenge and take up family medicine. Data from the Canadian Residency Matching Service shows that over the past few years, the number of medical students selecting family medicine programs as their first choice has plateaued.

The last thing we want to see in the midst of a pandemic is our brightest medical students straying away from family medicine due to fears of uncertainty and irrelevance fueled by uncertainty around COVID-19, inadequate PPE, the impact of virtual care on patient outcomes and whether compensatory structures for remote care will be supported by governments after the pandemic.

Instead, we should focus on the tremendous and diverse roles family physicians have played and the flexibility the field has shown in adapting. Though primary care is the cornerstone of our health-care system, some will say uncertainty is the cornerstone of family medicine – though we are often the first line of defence when a health need arises, we are often the last line of patient support for uncertain, unexplained diagnoses and likely best equipped to provide this relationship-based care.  

As someone who has dedicated the prime of her career in family medicine to helping lead the admissions process to a large family medicine residency training program, I urge applying medical students across the country to seriously consider primary care at this crossroads of their training and time of change, growth and tremendous progress in the field.

Our health-care system needs strong family physicians to face the long-term impacts of COVID-19 on our patient populations for years to come. 

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3 Comments
  • Andy Ratana says:

    “The noticed decreases in immunization inclusion may leave small kids and networks defenceless against antibody preventable sicknesses like measles,” the creators noted.

  • Randy Filinski says:

    I am a patient who for the past 20 months, pre COVID and during COVID, have been triaged, diagnosed and treated by the most incredible medical team across many organizations. I have watched the landscape change from 98% in person visits to 60% virtual visits and feel that my healthcare plan is better because of this transition.

    Here is my key point: my journey began with my Primary Care team (FHO) and moved where needed but am now returning to my local team. They maintained a connection with me throughout the journey and it is all about a relationship, both clinically and personally with myself and my partner.
    In medical terms, I call this “The Patient Medical Home” and the article is so in tune as to the value of this relationship.
    I hope that our new physicians and practitioners see this as an incredible and rewarding career path because we respect, trust and need your support.

    Thank you for writing.

  • Ashwin Pillai says:

    So well written. I think no other specialty connects so well to a patient other than a family physician. The holistic approach of a family physician and their role as a first-line defence especially in such unprecedented times is undeniable.

Author

Vanessa Rambihar

Contributor

Vanessa Rambihar is a family physician practicing at Women’s College Hospital in Toronto, where she is responsible for the Family Practice Health Centre’s implementation of Virtual Care. She is also an assistant professor and associate program director for the Department of Family and Community Medicine at the University of Toronto, where she leads the residency admissions process.