Ontario science table details plan to improve primary care

Posted on October 5, 2022 in Health Delivery System

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TheStar.com – Opinion/Editorials
Oct. 5, 2022.   By Star Editorial Board

Those who deliver primary care play a “unique role . . . given the long-term relationships and trust built with patients over time,” the science table stated.

It’s perhaps fitting that Ontario’s COVID Science Advisory Table used their final report to put a spotlight on an issue that is both the foundation and frontline of health care – primary care.

Primary care, the expert advisors wrote, is the “critical entry point” to both COVID-19 related care as well as care for other health concerns. Yet many people in Ontario do not have a doctor, leaving them without an “important access point to comprehensive and continuous care,” they cautioned.

The shortage of family doctors is well-known. But the report’s observations on the role of primary care practitioners in providing COVID-19 care underscores the benefits, necessity even, of having a family doctor, to patients and the entire health system.

Those who deliver primary care play a “unique role . . . given the long-term relationships and trust built with patients over time, their role in care coordination and their commitment to whole-person care,” the report said.

For example, they have been “trusted sources of vaccine information, education and outreach,” particularly into racialized and Indigenous communities to build trust in COVID-19 vaccines.

It cited research that found in 2021, people without a family doctor were less likely to be vaccinated against COVID-19. Doctors were a trusted source of information against a backdrop of vaccine misinformation, it found.

That all speaks to the benefits of having access to a family doctor – illness prevention, early detection of health problems, sound medical advice. And it underscores the potential health consequences for those without one, such as neglected health and delayed treatments.

No wonder then that health systems that provide robust primary care achieve better health outcomes at a lower cost, the report notes.

Yet in 2020, nearly 1.8 million people in Ontario did not have regular access to primary or were only “loosely connected” to a provider, the brief stated. The Ontario College of Family Physicians estimates that over the next three years, that number could rise to more than 3 million.

This as the burden on primary care is expected to grow. Primary care practitioners continue to deal with the health fallout of the pandemic but also the backlog of deferred treatments, together with the rise in mental health and addictions issues seen since COVID-19 hit.

With a population of 14.8 million people and another 5.6 million expected over the next 25 years, Ontario faces a “significant challenge” in meeting what the panel describes as a “large and growing demand” for primary care.

“On any given day, many more Ontarians need to access a primary care clinician than hospital or specialist services,” the report said.

The science table observations provide compelling evidence to make investments to improve access to primary care and family doctors. The province took some steps earlier this year to boost the number of medical school and residency spots over the next five years. Yet the extra spots – fewer than 500 – aren’t likely to meet the demand, considering that 1.7 million Ontarians have a family doctor who is over 65 and could retire, according to the family physicians’ college.

We’ve written before about the issues that deter young doctors from going into family medicine, such as the administrative burdens that come with running an office. As well, family doctors want to work as part of a primary care team, with other healthcare professionals such as nurses, pharmacists and social workers. The brief urges a comprehensive strategy to deal with some of these concerns, suggesting primary care delivery is currently a patchwork. And it urges action to develop primary care teams.

The science table, now disbanded by the province, provided much independent advice and insights over the course of the pandemic. Its lengthy last report might rank as among its most important.


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