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Your check-up is in the mail
Soon, a big brown envelope from your doctor’s office might arrive in your mail box. In it will be a booklet, a letter and a consent form. It means your physician is forming a family health team and wants you to be a part of it.
While your doctor remains the focal part of the team, he or she will be working alongside nurse practitioners, dietitians, social workers and other health care providers.
“You have the family doctor, but on any given day you may see someone else,” said Don Harterre, physician lead of Peterborough’s family health teams, which have been operating for a year. “Patients seem very accepting of that because they can often get in sooner and spend more time with that person than they could have with the family doctor.”
For example, instead of working out a weight-loss diet with you, your doctor might refer you to the team dietitian. And, while you’re with the dietitian, the physician will be seeing someone else. Under this system, the Ministry of Health and Long-Term Care expects each family doctor will be able to care for up to 50 per cent more patients, helping alleviate the shortage of family physicians. The benefit to patients is obvious: each is cared for by a team of health professionals, unique to their individual needs.
Dr. Nick Kates, a psychiatrist and program director of the Hamilton Family Health Team, has found that access to care for mental health patients has increased since that team was formed in June.
“People in the program do well,” he said. “They like being seen in their family doctor’s office compared to being seen in a mental health clinic. That care is better co-ordinated. Communication is much improved because everybody’s working on the same site. Everybody’s charting on the same record, so there’s much less confusion. And the vast majority of health care can be delivered in primary care if you have the experts or the expertise available.”
Care can be supported by an electronic charting system that helps organize health information, manage medications, access test results and monitor the progress of your treatment plan.
Family health teams hire the health professionals appropriate for the needs of their own community, but for every one, a nurse practitioner plays a key role.
Nurse practitioners are registered nurses with advanced, specialized training. Working within strict guidelines, nurse practitioners can take patient histories, do physical exams, stitch cuts, make diagnoses, give immunizations, order certain tests, prescribe some medications, educate patients in health promotion and disease prevention and care for those with chronic illnesses.
At any time they can consult a physician about the patient’s treatment.
The present provincial government announced family health teams in April 2005, building on the idea of family health groups developed by the previous government. The idea was slow getting off the ground.
In part the problem came from how nurse practitioners were paid. Before family health teams, nurse practitioners could not bill OHIP independently. Instead, doctors had to bill OHIP on their behalf and, to do so, had to see the patient as well, defeating the whole purpose of the nurse practitioner role.
Now nurse practitioners are paid separately and doctors are paid a fixed yearly sum for each patient on the family team roster instead of the standard fee-for-service.
This means doctors are better compensated, making family medicine a more attractive specialty than it has been.
The family health team doctors remain on around-the-clock, rotating call for the team’s patients. Your end of the deal is, unless it’s an emergency or you’re travelling, you call your family health team first.
Of the 150 family health teams proposed by the government, 53 are up and running and another 72 are at some stage of the application and approval process, including one at Southlake expected to launch in March.
Because of the family health teams, Dr. Harterre knows of at least two physicians attracted to family medicine, because of the higher pay and shared duties.
So, there must be drawbacks. “Not really,” Dr. Kates said. “Even those (doctors) who were dubious or a bit skeptical in the beginning, without exception, say they’d never go back.”