Ontario Science Table Details Primary Care Improvement Plan
It is perhaps fitting that the Ontario COVID Science Advisory Table has used its final report to shine a light on an issue that is both the foundation and the front line of health care: primary care.
Primary care, the expert advisers wrote, is the « critical entry point » for both COVID-19 care and other health conditions. Yet many people in Ontario do not have a doctor, depriving them of an “important point of access to comprehensive and ongoing care,” they warned.
The shortage of family doctors is well known. But the report’s findings on the role of primary care practitioners in providing COVID-19 care underscore the benefits, if not the necessity, of having a family physician, for patients and the entire health care system.
Those who provide primary care have a “unique role. . . given the long-term relationships and trust built with patients over time, their role in coordinating care, and their commitment to holistic care,” the report states.
For example, they have been « trusted sources of vaccine information, education, and awareness, » particularly in racialized and Indigenous communities to build trust in COVID-19 vaccines.
He cited research that found that in 2021, people without a family doctor were less likely to be vaccinated against COVID-19. Doctors were a reliable source of information amid misinformation about vaccines, he found.
All of this speaks to the benefits of having access to a family doctor – disease prevention, early detection of health problems, sound medical advice. And it underscores the potential health consequences for those who don’t, such as neglected health and delayed treatment.
It’s no wonder, then, that health systems that provide strong primary care achieve better health outcomes at lower cost, the report notes.
Yet in 2020, nearly 1.8 million people in Ontario either lacked regular access to primary education or were only « relatively connected » to a provider, the brief says. The Ontario College of Family Physicians estimates that over the next three years, that number could grow to more than 3 million.
This at a time when the burden on primary care is expected to increase. Primary care practitioners continue to deal with the health fallout of the pandemic, but also the backlog of deferred treatment, as well as the increase in mental health problems and additions seen since the hit of COVID-19 .
With a population of 14.8 million and an additional 5.6 million expected over the next 25 years, Ontario faces a « significant challenge » in meeting what the committee describes as « significant and growing » primary care.
« Every day, many more Ontarians need access to a primary care clinician than to hospital or specialist services, » the report says.
The findings from the science table provide compelling evidence for making investments to improve access to primary care and family physicians. The province took steps earlier this year to increase the number of places in medical schools and residencies over the next five years. Still, the additional spaces — less than 500 — are unlikely to meet demand, given that 1.7 million Ontarians have a family doctor over the age of 65 who may be retiring, according to the College of Family Physicians.
We’ve written before about the issues that deter young physicians from entering family medicine, such as the red tape that comes with running a practice. Additionally, family physicians want to work as part of a primary care team, than other healthcare professionals like nurses, pharmacists, and social workers. The brief urges a comprehensive strategy to address some of these concerns, suggesting that primary care delivery is currently a patchwork. And it calls for action to develop primary care teams.
The science table, now disbanded by the province, has provided much independent advice and insight during the pandemic. His long last report could be among the most important.