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We must put primary care first

Posted May 25th, 2023

This is an opinion column by Niagara Health President and Chief Executive Officer, Lynn Guerriero, published in the St. Catharines StandardNiagara Falls Review and Welland Tribune

It’s the foundation of Canada’s healthcare system. It’s vital to preventative care, health education and the management of chronic conditions.

Importantly, it’s where patients turn for care when they are sick with a non-emergent illness. I’m talking about comprehensive primary care.

At first glance it might seem odd for a hospital leader to discuss this topic. But our healthcare system is inter-connected; when one part isn’t working well it’s felt in other parts, from hospitals to emergency medical services to long-term care. At Niagara Health we feel it most in our emergency departments (EDs), which patients often turn to as a result of limited access to primary care. This in turn generates longer wait times for ED care and diagnostic imaging.

Today in Ontario, 2.2 million people are without a family doctor, and that number continues to grow. In Niagara, we are short nearly 100 family doctors. We know there are several reasons for it. Most notably, significant challenges in access to health human resources, leading to burnout for the healthcare workers we do have, and recent shifts away from comprehensive family medicine.

This isn’t just a Niagara problem. Significant gaps in primary care are creating pressure on already overtaxed parts of the healthcare system. At Niagara Health, we are suffering with our own physician shortages, including in our EDs in St. Catharines, Welland and Niagara Falls. Couple this with the volume of patients visiting EDs for issues better managed by a family doctor, and it’s no wonder we see long wait times.

We need to do two things. The first is getting more clinicians into our primary care system. The second is to properly fund comprehensive, team-based models of primary care delivery that ensure same-day and next-day appointment availability to their rostered patients.

Both hinge on attracting and training future doctors and healthcare workers. While these future healthcare heroes work their way through the education system and into our talent pipeline, Niagara Health is working beyond the walls of our hospitals to manage the urgent ripple effects of today’s primary care problem and, most importantly, to meet the needs of Niagara residents.

Taking on the additional responsibility for primary care stretches the role of an acute care hospital. At Niagara Health, our teams are trained to provide acute care hospital services to the 450,000 residents across the region. And we operate one of the busiest emergency medicine programs in Ontario.

Our work to address the primary care problem includes launching the Seamless Care Optimizing Patient Experience model, better known as SCOPE Niagara. A strategic partnership between Niagara Health, Niagara Practitioners Healthcare Alliance and Home and Community Care, SCOPE Niagara is a locally based, virtual interprofessional care team that supports primary care providers through a single point of access. I’m incredibly proud of this initiative, which has the potential to fill gaps in primary patient care today.

We are also adding a chief of primary care role at Niagara Health because we understand how important our partnership with primary care is. This role will further strengthen that partnership and help to lead our efforts to increase access to primary care for Niagara residents.

We’re also working with our partners in healthcare, government and post-secondary education to build our clinical capacity in the short and long term so no patient is left behind.

But unlocking access to primary care cannot be solved on a local level, and certainly not by a single hospital system. This is an issue that is provincial and national in scope, one that requires innovative thinking and collaboration.

To date, the Government of Ontario has taken important steps to connect more people to care faster, including enabling pharmacists to prescribe medications for common medical ailments. This initiative makes good sense and serves as a viable alternative to visiting a local hospital for non-emergency needs. We are also optimistic about the government’s commitment to introduce additional interdisciplinary primary care teams across the province.

To build up patient care, we must devote attention to every pillar that makes up our healthcare system. Prioritizing comprehensive primary care will go a long way towards alleviating existing pressures, shortening wait times, and ensuring every resident has access to care.

Niagara Health System