President's Message - April 2017

David White, MD, CCFP, FCFP

Primary care transformation: Hands across the border

Primary care is changing, continuously and relentlessly. As doctors we yearn for improvement grounded in evidence, and it is clear that family physicians need to engage in producing that evidence. In March I had the opportunity to attend a cross-border primary care symposium in Washington, DC, that was dedicated to this bold and necessary undertaking. Its title was Advancing the Science of Transformation in Integrated Primary Care: Informing Policy Options for Scaling-up Innovation.

Approximately 150 leaders in primary health care delivery, policy, and research from Canada and the United States came together at the symposium. Our agenda included sharing evidence-based success stories, identifying opportunities to advance system-wide primary care innovation, and developing a bi-national research agenda on primary care transformation.

The symposium quickly dispensed with many of the myths that persist about differences between Canadian and American approaches to, and outcomes in, health care. In fact, the overriding problem we face is identical: We both rank near the top of Organisation for Economic Co-operation and Development countries for total health care costs and near the bottom for health outcomes. We also face similar challenges in primary care transformation, including costs, health equity, multi-morbidity, patient engagement, care of vulnerable populations, and leveraging advances in health information technology.

One point that came up was that when we achieve success in innovation at the local level, we often do not see it scaled up at regional and national levels. The College of Family Physicians of Canada (CFPC) has been making strides in this area, most recently with our new Innovation in Primary Care series. It shares case studies of successful initiatives from across Canada with the goal of inspiring others to take up similar actions to improve care where they practise. I encourage you to look at the first issue in this series and consider sharing details about your own initiatives in a future issue.

At the symposium we learned about the United States’ vast potential for innovation. This potential exists not only through its many private funders and players but also within its publicly supported systems, including Medicaid and Veterans Health Administration institutions. Symposium speakers shared some exciting efforts that are currently under way. The symposium also opened the door to extraordinary prospects for researchers and leaders in Canada and the United States to work, research, and learn collaboratively to improve primary care in both countries.

Engaging in this dialogue demonstrated the CFPC’s important role in and ongoing commitment to advocating for research to support the evidence-based transformation of primary care.

David White, MD, CCFP, FCFP

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