By Michelle Read
Writer
When COVID-19 hit earlier this year, it quickly revealed a disparity in how family doctors were impacted by the pandemic across the province.
Only 25% of family physicians work with funded interdisciplinary teams (e.g., a family health team), and are paid a set amount based on how many patients are in the practice. The other 75% are in practices without those funded supports, and the majority of those are paid largely fee-for-service. During the pandemic these practices were more financially impacted by the reduction of in-person visits, and some of these practices throughout the province were forced to close.
“The pandemic has laid bare many pre-existing gaps in our health system,” says Dr. Elizabeth Muggah, a family physician and an associate professor in the Faculty of Medicine’s Department of Family Medicine.
As its newly minted president, Dr. Muggah is looking forward to working with the Ontario College of Family Physicians (OCFP) to move the province toward a model in which all family physicians have access to team-based care. It’s known as the Patient’s Medical Home, which Dr. Muggah refers to as the “North Star” vision for health care in Ontario.
“Every family physician should have access to an interconnected system with an interdisciplinary team to help them with their most complex patients,” says Dr. Muggah, explaining that the evidence points to the Patient’s Medical Home as being better for patient care and reducing the burden on the health system with fewer hospitalizations and emergency department visits. The OCFP has been advocating for the idea of a “minimum team” to support those practices who do not have funded interdisciplinary team supports.
Dr. Muggah brings many years of research into health systems and primary care to her role as OCFP president, as well as a Master’s in Public Health from Harvard and lessons learned from having practiced comprehensive family medicine in Canada and abroad.
“We’re in a fascinating time of political change,” she says. The election of a new provincial government in 2018 led to the introduction of significant health system changes with the launch of Ontario Health and Ontario Health Teams, the latter of which Muggah embraces as “a huge opportunity to take a good look and say, how do we envision better integrated care in our communities?”
Leadership development and capacity building essential
Representing the province’s 15,000-plus family physicians, the OCFP structures its activities to reflect the needs of its membership. The College’s pillars include education and continuing professional development for family physicians; advocacy that supports the role of family physicians within a provincial health system that enables accessible and high-quality care for patients; and policy research related to family physicians and health system reform.
A fourth pillar is leadership development and capacity building for family physicians—essential, says Dr. Muggah, in supporting family doctors in participating in the current health system transformation efforts, and to improve health care for patients by strengthening Ontario’s primary care system.
“Family doctors play such a critical role in making the whole system work,” she says. “Why haven’t our hospitals been overrun during the pandemic? A big part of this is the hard work of family doctors in the community to get patients the care they need so they don’t end up in emergency departments.”
Dr. Muggah praises the strong leadership in the University Ottawa Department of Family Medicine, and the Department’s focus and nationally recognized achievements on health system research. “With so many great leaders locally, this is also real opportunity for family doctors in the Ottawa region to help shape how health care is delivered,” she says.
Physician wellness is a priority for Dr. Muggah; as current assistant dean of the Faculty Wellness Program, she is keen to bring the lens of her wellness work to the provincial level and share it in the best interests of the physicians the OCFP represents.
“I’m eager to explore how we can bring the problem of increasing physician burnout front and centre, and how we can support health care organizations to be environments that promote the well-being of providers,” says Dr. Muggah, noting that a strong health care system has to consider the health of its physicians and other providers.
COVID-19 may have exposed weaknesses in health care, but Dr. Muggah feels the pandemic has opened up chances to build and improve, and many new possibilities such as virtual care.
“There are some exciting opportunities right now to make positive change for Ontario’s family physicians and their patients,” says Dr. Muggah.
