Tag Archives: primary care

Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Was I wrong!

Pioneering Professional Practice doesn’t sound like the most stimulating title of a Plenary Address but Helen Stokes-Lampard, Chair of the UK's Royal College of General Practitioners (RCGP) Council, gave an uplifting, encouraging and inspiring address on the topic on day 2 of the SAPC ASM 2017. Helen encouraged us all to rediscover the joy and sparkle of general practice despite poor morale, a constant feeling of being under siege, and increasing resource limitations in the profession. I liked her analogy that primary care, secondary care and social care were interdependent and need to be together- a three legged stool that depended on all three components to remain stable. ...continue reading

Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Shakespeare’s Warwickshire was the background to last week's 46th Annual Scientific Meeting of the Society of Academic Primary Care (SAPC) where Professor Christine Ennew, Provost of the University of Warwick, introduced the meeting by emphasising the importance of primary care in the development of their young medical school. She also underlined her belief in the transformational power of universities and how their contribution to academic medicine can alter clinical practice.

It saddened me that her optimism and enthusiasm contrasted with the stark reality of general practice as outlined by Candace Imison, Director of Policy at the Nuffield Trust ...continue reading

Did you hear about Chris’s mint condition 1963 Shelby Cobra? Mechanics say he didn’t check the oil for decades, and the engine just seized one day on the way to work. When they opened it up, they say there wasn’t much left. Such a shame really.

Said Nobody. EVER.

Jazlin Mayhue is a researcher in Victoria, BC

Peter Hobza is a family physician in Victoria, BC

Robert O'Connor is a family physician in Victoria, BC

 

Introducing a new concept...

We all know folks who are not vigilant with preventive health for their body. However, a subset of them wouldn’t drive an irreplaceable million-dollar car until it was destroyed from lack of maintenance. A human’s life and body are irreplaceable, and worth at least a million dollars, when considering the price of an injury causing death. Therefore, it’s logical to help some people think of treating their body as well as a valuable car. ...continue reading

Arlene Bierman is the Director of Center for Evidence and Practice Improvement (CEPI) at the United States Agency for Healthcare Research and Quality (AHRQ)

Rick Glazier is a Family Physician and Senior Scientist and Program Lead of Primary Care and Population Health at the Institute for Clinical Evaluative Sciences (ICES) in Toronto, Canada

 

Primary care is foundational to optimizing individual and population health. Health systems based upon primary care provide better access to care while improving health equity and outcomes and reducing costs. Effective models of primary care can greatly enhance the value of increasingly constrained health care spending. Despite large investments on primary care transformation in the US and Canada, primary care has yet to achieve its full promise in either country. Sharing successes and failures from attempts at innovation on both sides of the border can help each country accelerate improvement.

Despite very different health systems, primary care practices in both countries encounter remarkably similar challenges in delivering care. At the point of care, patients’ needs are similar and their experiences too often suboptimal. ...continue reading

Robyn Tamblyn is the Scientific Director of the Canadian Institutes of Health Research Institute of Health Services and Policy Research, and a Professor in the Departments of Medicine and  Epidemiology & Biostatistics in the Faculty of Medicine at McGill University, Canada

Andrew Bazemore is a practicing physician and the Director of the Robert Graham Center – Policy Studies in Family Medicine & Primary Care -  in Washington, DC

 

Yehuda Berg, an American author and spiritual leader, was probably talking about individual level transformation when he said “We need to realize that our path to transformation is through our mistakes. We're meant to make mistakes, recognize them, and move on to become unlimited.” But the statement has a lot of validity even applied to system level transformation.

Canada and the United States share the dubious honor of ranking near the top of OECD nations for total healthcare costs and near the bottom for health outcomes, whether measured in terms of individual health or health system performance. But it is through the recognition of these mistakes that both countries have embarked on a path toward transformation.

While differences between the two systems of health care delivery are frequently emphasized, we actually face some common challenges to primary care transformation ...continue reading

Domhnall_MacDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He is currently attending the North American Primary Care Research Group (NAPCRG) annual meeting in Colorado Springs, CO.

 

Not many primary care doctors have an 8 billion dollar budget. Mitch Katz, who gave the opening keynote address at NAPCRG 2016, is director of the Los Angeles County Health Agency which combines the Departments of Health Service, Public Health and Mental Health into one service. He continues to see patients and described how he had become so specialised in his career in a primary care AIDs clinic in San Francisco, that he found returning to generalist practice extremely difficult. When he focused on AIDS he was on top of his topic like any specialist, but, as a generalist, he had to cope with anything from a heart attack to broken heart.

Los Angeles, until recently, had no ambulatory care ...continue reading

griswoldKim Griswold is Associate Professor of Family Medicine, Psychiatry, and Public Health and Health Professions at Jacobs School of Medicine and Biomedical Sciences in Buffalo, New York. Dr Griswold will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.

 

Communities in every nation are faced with providing competent, equitable and culturally appropriate services for resettling refugees. Health centric disciplines are not enough to meet the challenges presented by these newly arriving populations, nor to alleviate the disparities they face – such as isolation, limited English proficiency, differences in patients’ attitudes and health literacy levels, and a lack of cultural awareness on the part of providers.

Health inequity can be defined as: “unjust differences in health between persons of different social groups.” ...continue reading

harrisMark Harris is Foundation Professor of General Practice and Executive Director of the Centre for Primary Health Care and Equity at the University of New South Wales in Australia. Dr Harris will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.

 

After working with refugee populations resettled in the urban fringe of Sydney in the 1990s, I began volunteer clinical work in 2000 with an NGO working with asylum seekers.  Asylum seekers do not have access to the national health insurance system that funds primary care for all Australians and subsidizes medications.  Despite having greater health needs due a variety of acute and chronic physical and mental health problems, refugees often suffer worse access to health care in resettlement countries like Australia. ...continue reading

hauckfFern R. Hauck is Professor of Family Medicine and Public Health Sciences at the University of Virginia. Dr Hauck will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.

 

The scope of the crisis is staggering!  The number of people displaced by war, conflict or persecution has hit a record high—over 65 million with 21 million of these being refugees. Most face an uncertain future. Those who are resettled to a developed country are among the lucky ones. Nonetheless, they face many challenges in their new home, including accessing culturally sensitive health care.

My involvement with refugees began on the Thai-Cambodian border, where I spent a year providing primary health care to Cambodian refugees who were living in the largest border camp, having fled there after the Khmer Rouge were ousted after years of genocide. Moving to Charlottesville, Virginia, in 2000, I never expected to find that refugees were being resettled in this small city. ...continue reading

1 Comment

Domhnall MacAuleyDomhnall_Mac is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.

 

Dear Linda,

I have just read your book - or, should I say, it completely captivated me. I couldn’t put it down. What a compelling life story. When you lectured about depression at those Masterclass lectures I chaired years ago I was so impressed with your grasp of the topic, your understanding of the difficulties facing family doctors, and your overall approach to managing the condition. You had such a clear understanding and appreciation of depression and the difficulties of treating it in practice. And, you were so assured, confident, on top of your subject. I had chaired many similar sessions but yours were outstanding. There wasn’t even the slightest hint that your understanding extended so far into your personal experience. ...continue reading