One of our biggest challenges: The End

DFM_Burge_IMG_0633Fred Burge is a Professor in the Department of Family Medicine at Dalhousie University, Nova Scotia.

 

Finally, a plenary session at NAPCRG on dying. For over twenty years I’ve come to this annual meeting as ‘the’ place to be nurtured as that oddest of breeds in medical research, a family doctor. Early in my academic life I thought I wanted to be a full time palliative care doctor. But over time I realized I loved long relationships with patients, sharing their experience with illness, helping them stay healthy and most compelling to me was being with them at life’s tough moments. What I call the transitions. New heart attacks, the diagnosis of multiple sclerosis, cancer diagnoses, depression, relationship challenges and so much more. Being a palliative care doc seemed only to work at the end of all of this. So, I moved back to being and loving family medicine. But, I felt passionately that because of the reasons I moved back, we family docs have a special opportunity and obligation to fulfill in end of life care. So what was the research attached to that? Lots! Does continuity of care matter? How can home visits play a role? Does advanced care planning work in primary care settings and how? How can primary care integrate best with specialist care? How can EMRs help us identify those at risk of dying in our practices? How can we organize to do this better?

Now with the relentless aging of us boomers, there is a lot of dying to deal with as a society. By the year 2056, the number of Canadians dying per year will actually double. That’s a lot of dying. The good news is we’ve got time to get it right.

Here at NAPCRG the attention to research on how best to organize and deliver our care to those with advancing chronic illness to achieve the best possible patient and family outcomes while respecting our financial realities is a central theme. How do we support new expanding collaborative teams in primary healthcare to work best for patients at the end of life? What new roles for novel providers might we create like paramedics in Nova Scotia who are engaging in this care? How can we use new technology to improve communication between healthcare providers and patients and families? How might new funding models and the policies that support them impact care delivery? Innovation in primary healthcare delivery must serve our society across its life course. The end is one of our biggest challenges. NAPCRG’s classic incubator of clever people with good ideas from around the world will help.

This blog is one of a series from the 43rd North American Primary Care Research Group (NAPCRG) Annual Meeting, which runs from October 24-28, 2015, in Mexico. CMAJ is one of the sponsors of the meeting.

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