Involving the people who matter most to improve health care

November 13, 2014

My interest in health care is personal and generational – I want my kids and their kids (and all Canadians) to have timely access to quality care.   What a great time to reflect on real system change in health care.

Last year, I led the work of the Vancouver’s A GP for Me initiative.  Through that process, which held great promise for increasing the capacity of primary care in Vancouver, we carried out an unprecedented engagement of family doctors and citizens.  Starting with family doctors and staff from Vancouver Coastal Health and Providence Health Care, we framed the issue around the fundamental nature of the therapeutic relationship, which resonated strongly with doctors.   They identified and shortlisted the most feasible and impactful strategies for improving primary care, both in clinical settings and across the sector.  This work involved over 500 family doctors, which means that about half of all family doctors in Vancouver helped to define these.

We distilled those ideas that had relevance or would impact citizens as they made use of health care, and then took those ideas to the people of Vancouver.   Again, we approached citizens through the same lens that we used for doctors:  the importance of the doctor-patient relationship.  Through on-line and in-person engagement of several thousand citizens, we found a few exciting things:

1.    Both doctors and patients / citizens feel strongly that everyone should have a family doctor, and everyone understands the gap it creates when someone doesn't have a primary care provider;

2.    Both would prefer that a patient see their family doctor rather than a walk-in clinic or the Emergency Department

3.    Both would be willing to make trade-offs to improve the strength of their primary care relationship, and make it more convenient to seek care at their family doctor’s office.

Based on these and many other findings, the Vancouver Division developed a plan and has received funding to implement changes and work in partnership with the health authorities.  I have high hopes that the resulting projects will be the seeds of primary care improvement in this great city. 

It’s also led me to reflect on the nature of the health care system itself and how we can involve citizens at a deeper level - in shaping the system of care - without requiring everyone to become fully educated on the nuts and bolts of the health care system.  In my next blog, I’ll start to describe some of the different disciplines that I think we can combine to involve all of us in improving a system that is so vital to our sense of national identity and to our lives.