Primary Care for People and Providers

For the past year, I’ve been writing, discussing and envisioning a new approach to sustainable and accessible primary care in BC.  Today, the Vancouver Citizens Health Initiative launches our non-profit organization, our website and shares our blueprint for a new model of primary care. 

As a group of citizens, we’ve been wrestling with how our children’s generation will have access to excellent, universally accessible healthcare.  Over five years of involvement in primary care innovation in BC, we’ve heard the best ideas for improving health care from over 500 Vancouver family physicians, system experts and 2000 citizens.  

The challenges are significant:

·      Health care costs already consume 44% of the provincial budget.

·      Over twenty percent of Vancouverites do not have a family doctor. 

·      Even if people have a doctor, getting a same-day appointment with them is rare, pushing patients to walk-ins and emergency departments;

·      A culture shift is occurring among younger family physicians, moving us away from the “do it all myself” ethos of previous generations of doctors;

·      The dominant payment approach (fee for service) rewards piecework – the antithesis of whole-person care.

We have taken these and other elements apart, put them under a microscope to find positive potential, and put them back together in a way that responds to what’s needed from primary care now:  a focus on strong therapeutic relationships, a medical home that is designed to provide whole-person care and a culture that continuously creates collaboration.  For the past year, we’ve been testing our ideas with numerous clinicians and citizens in a spirit of continuous improvement.

Here’s what we’re designing primary care to do:

·      Double the capacity of family doctors to attach patients, while maintaining revenue and work-life balance for clinicians;

·      Enable and encourage patients to have same-day and evening appointments;

·      Expand the care team to support patients based on their life circumstances and income level;

·      Do all this within the fee for service payment approach.

We invite you to become part of the conversation and the work of building this new approach to primary care.  Please visit our site, let us know what you think, and stay connected.  We’re at the beginning of our journey and want you to participate!