Primary Care

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Domhnall MacAuleyDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He's currently also Chair of the Jury for the National Research Award of the Swiss College of Primary Care Medicine

 

Swiss primary care research has a very bright future, from what I could see at the early career researchers meeting (TAN HAM) that I attended recently in Bern. Oliver Senn put together a superb programme but the key to its success was the commitment and contribution of the researchers. It was their programme and, not only did they present their work with skill and style, and almost exclusively in English, but each research presentation was chaired by one of their peers as the senior academics looked on from the side lines. The presentations were fantastic, covering a range of topics, as described below. But I thought the peer chaired sessions were an innovation worth replicating at other national and international meetings.

Many countries are struggling to recruit and retain a family medicine workforce and Switzerland is little different. ...continue reading →

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

 

In my capacity as Chair of the Jury for the National Research Award of the Swiss College of Primary Care Medicine, I was recently invited to give a Plenary lecture at the Early Career Researchers Academic meeting for academic primary care physicians in Bern, Switzerland. I enjoyed listening to other great speakers at the event. One was Kali Tal, a professional writer, who, in addition to her many other talents and accomplishments, works as a senior Editor, grant writer and qualitative researcher at the Institute for Primary Care Medicine at the University of Bern. Kali gave a workshop on research writing at the recent early career researchers’ group meeting.

Many researchers struggle with writing research papers, grants and reports. ...continue reading →

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Barbara Zelek is Associate Professor and Co-Chair for the Section of Family Medicine at the Northern Ontario School of Medicine

 

Marathon, a rural community on the North shore of Lake Superior, made CMAJ headlines in 1997 because it boasted a stable workforce of seven physicians for the first time in over a decade. 2017 marks the 20th anniversary of that CMAJ article and of the arrival of Dr. Sarah Newbery and Dr. Eliseo Orrantia in Marathon.

The article described “a medical renaissance” taking place in Marathon and an end to “the revolving door that has affected rural medicine across the country”. That door has stopped revolving in Marathon since 1997 thanks, in many ways, to the leadership of Eli and Sarah.

Let me put this important milestone in context. ...continue reading →

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

 

Have we lost something in the success of academic family medicine? We produce quality research, have created successful interdisciplinary academic teams, demonstrate competitive publication outcomes and generate significant grant income. But, academic primary care may have drifted away from, and perhaps even alienated, some family medicine colleagues. There are thoughtful and reflective family doctors who read, write, discuss and debate many aspects of general practice but feel undervalued as they do not fit the university based academic profile. ...continue reading →

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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 →

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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 →

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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 →

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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 →

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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 →

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

 

The concept of the “Salon” is based on the tradition of European intellectual gatherings that led to the great literary, artistic and political movements of our time. At a recent meeting of primary care researchers in Colorado Springs, Frank deGruy gathered a group of colleagues in this way together to create discussion, debate and perhaps generate ideas. Such gatherings might take place with any group and in any context - in a department, region or nationally. On this occasion, Frank attracted a group of about twenty delegates of the NAPCRG meeting from various international and professional backgrounds and I was fortunate enough to be included. ...continue reading →