Understanding Ontario’s health care system is a no easy feat. Understanding the ways in which you can receive primary care in Ontario can be even more challenging.
Previously, we discussed the 700,000 people in Ontario that don’t have access to a primary care provider. Now, let’s take a step back and define what “primary care” is and what it means. Primary care is your main point of entry into the health care system. It is where your health care needs or concerns are initially assessed. Your family doctor acts as the leader of this care. In Ontario, family doctors can provide health care services to patients in two ways – in a solo-setting or in a group-based model of care.
Solo practice, for many years, has been the traditional way that many family doctors practiced medicine. In this model, doctors set up independent practices, usually with few support staff, and receive payment for each individual service – tests, assessments, procedures – they provide to their patients. This is known as “fee-for-service” (FFS). The Comprehensive Care Model (CCM) is a version of the fee-for-service model where doctors enroll patients under their care, and patients sign an agreement with the doctor. Docs who practice within the CCM model provide some after hours care on evenings and weekends, giving you more flexibility when it comes to booking appointments and having access to care.
Group-based models of care:
Family Health Groups (FHGs), Family Health Networks (FHNs) and Family Health Organizations (FHOs) are three different models of group-based primary care that hold many similarities. In these models, doctors usually work in groups of three or more, and patients are typically enrolled under the care of one doctor. Doctors provide some after-hours care on evenings and weekends. This is to keep less serious injuries and illnesses out of walk-in-clinics and emergency departments, keep wait-times down, and lessen the strain on hospital resources.
A growing and aging population means chronic diseases such as diabetes, arthritis, and high blood pressure are becoming more common in older Ontarians. Therefore, the Ontario government has urged doctors who practice in team-based models to focus on the prevention, treatment, and management of chronic diseases and health promotion. So, if you are a patient with a chronic disease, such as diabetes, your doctor will focus on diagnosing and treating your disease, and will help you manage your chronic disease in order for you to live a healthier life. A lot of patients and their families benefit from group-based models of care. These models are quite effective as patients can usually get a same day appointment, with either their doctor, or another doctor on the team, and they benefit from extended clinic hours.
The following are team-based models of care, but are NOT a part of the above primary care models:
In these models, doctors work as a part of an interdisciplinary-team with allied health professionals in order to provide comprehensive care to patients. Family Health Teams (FHT) are inter-professional teams of health care providers – family doctors, nutritionists, social workers, and other professionals who provide comprehensive care to patients enrolled within the FHT. For a doctor to join a FHT, they have to be a part of a FHO or FHN. Community Health Centres (CHCs) are inter-professional teams of physicians and other allied-health professionals who are salaried. They typically serve high needs populations that face difficulties when attempting to access or secure health care services.
Family doctors have traditionally been able to choose the type of model in which they want to work. Reasons can include personal preferences, the community in which they want to practice, and the model in which they have been trained. Current medical students and residents in Ontario are trained in team-based care models. The Ontario government is now limiting access to several of these models, specifically Family Health Networks and Family Health Organizations, in the community of their choice. This will make it harder for new doctors to provide you with integrated team-based care that they have been trained in.
No matter the model they practice within, Ontario’s doctors will always provide their patients with quality care. Ontario’s doctors always have and always will put their patients first.