Manitobans need to drive health reform

Opinion

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This article was published 07/06/2023 (854 days ago), so information in it may no longer be current.

Hardly a day goes by in Manitoba without health care being in the news — and much of the coverage is negative. While there are reports of good, even excellent, individual patient experiences, it is clear that urgent change is needed.

Our health-care system in this province is indisputably struggling. And there is one problem at the heart of our myriad health system challenges: too many Manitobans are struggling to access primary care.

Primary care is the front door to the health-care system. It’s typically delivered by family doctors and nurse practitioners, sometimes with other health professionals.

Family doctors should be the first point of contact when you have a new health issue. Family doctors also manage chronic conditions like diabetes and high blood pressure, help keep you well with immunizations and cancer screening tests, and co-ordinate care from other parts of the health system.

When people don’t have access to primary care, when they don’t have a family doctor and when the front door is closed, nothing works as it should; emergency departments become crowded, unnecessary medications may be prescribed, there are more missed or delayed diagnoses, and patients suffer the consequences.

We need to do better. But how?

For too long, our health-care system reforms have been mainly informed by “experts” — health professionals, people in government, researchers and administrators. We need bold reform to address the crisis at hand, and that reform needs to be driven by the public’s voice.

With this in mind, a team of researchers and clinicians launched OurCare, a national initiative to engage the public about the future of primary care.

To start, the team heard from more than 9,000 adults in Canada who responded to the OurCare national research survey about their experiences with primary care and what they want to see in a better primary care system.

The findings are alarming — and informative.

More than one in five people who responded to the OurCare survey reported not having a family doctor or nurse practitioner when they need care or advice about their health. Extrapolated to the population of Manitoba, that’s almost 300,000 people who don’t have access to a family doctor.

So, is the solution more family doctors?

Having more family doctors is an integral part of the solution, but we also need to rethink how family doctors work and how primary care is delivered. Primary care teams place family doctors, nurse practitioners and other health professionals together, to benefit patients. Done correctly, primary care teams can improve a patient’s health, offer joy at work for health-care team members, and increase the capacity of family doctors to care for more patients.

The OurCare survey found that people in Canada were supportive of team-based primary care. Ninety per cent said they were comfortable getting support from another team member if their family doctor recommended it. Yet few people said they had access to team-based care.

The OurCare survey also asked people what they thought was most important regarding primary care. People wanted primary care that looked after all their health needs, provided timely access, and helped them navigate other parts of the health system. But the most important aspect was having a family doctor or nurse practitioner who knew them as a person and considered all the factors that affected their health.

These patient priorities fit with what we know works. Many studies have shown that people get better care when they have an ongoing relationship with one family doctor who they continuously see for care.

The OurCare survey findings are just the start. In the next phase, OurCare will have deep dialogues with 36 Manitobans — volunteers who will be randomly selected to roughly match the province’s demographics.

These members of the public will meet for 30 hours to learn about primary care from experts and then deliberate to come to a consensus on the key issues to address and related recommendations. They will release a report in the fall summarizing their vision for primary care in the province.

The status quo isn’t working. We need to fix our primary care system and reforms need to be grounded in the public’s viewpoints.

It’s time we hear directly from Manitobans and co-create a future that works for everyone. Your voice matters. Help us by joining the Manitoba OurCare Priorities Panel. Visit OurCare.ca

Alan Katz is a family physician and professor at the University of Manitoba. Amanda Condon is a family physician and associate professor at the University of Manitoba. Tara Kiran is a family physician and scientist at St. Michael’s Hospital, Unity Health Toronto and the University of Toronto.