Chair's Message
A report has just been released from the Commonwealth Fund survey of primary care physicians in 10 countries asking about their readiness to care for patients with complex health needs. (Osborn R et al. Health Affairs 34, No. 12 (2015): 2104-2112.)
Primary care physicians were surveyed in 10 countries including Australia, Canada, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.
A preliminary look at the data suggests that primary care practices in Canada are not well prepared to manage the care of patients with complex needs. The percentage of Canadian practices that reported they were well prepared to manage patients with Dementia (42%), Palliative Care (42%), severe mental health problems (24%), substance abuse (15%), and multiple chronic conditions (70%) would suggest that more support was needed in many areas. Canada's ranking in most of these areas was poor compared to the other countries but it is important to note that all countries were struggling with the demands brought about by an aging population with complex medical conditions.
These numbers must reflect the diversity in healthcare across the country since delivery of healthcare is a provincial responsibility and there is some information that multidisciplinary team access is helpful for managing patients with multiple chronic conditions. The access to multidisciplinary teams varies province by province.
Canadian primary care practices also reported poor communication with specialists, hospitals, home care providers and social services, all components of a properly integrated healthcare system. Canadian practices also lagged behind other countries in the use of secure e-mail to maintain contact with patients and increase access.
To me, these data mean that primary care around the world struggles in managing patients with complex needs. Primary care needs better and more universal information technology, better access, better communication and system integration, and the support of the multidisciplinary team environment to cope with the multi-morbidity of today.
I discussed this further, and the need for better electronic communication systems for physicians in Canada via The London Free Press.
At this time of year let me take a moment to wish everyone a happy and healthy holiday season.
As always I welcome your comments at: stephen.wetmore@schulich.uwo.ca
