By Kathy Tudor, Ontario Patient and Director of Communications & Marketing, OntarioMD
Renowned physician and former federal Minister of Health, the Hon. Jane Philpott, MD, delivered the keynote address on day two of OntarioMD’s 2024 Digital Health Conference in Toronto. She spoke of a compelling vision for the future of Canadian health care, as presented in her book “Health for All”, a profound exploration of global health system challenges and opportunities, drawing on her medical experience and years of public service.
I expected to write this article about Dr. Philpott’s speech from my perspective as OntarioMD’s communications director, however as she spoke, I realized her message was personal for me. It was about my health-care circumstances and those of my family.
Dr. Philpott’s ideas hit home as I face losing my family doctor in the next few years. As an 80-year-old solo practitioner, I can’t expect my doctor to soldier on for much longer given the documentation burden and demands of a health-care system under pressure. I will become one of the 4.4 million, or one quarter of Ontarians expected to be without a family doctor, according to the Ontario Medical Association and the Ontario College of Family Physicians. I feel like I’m at a crossroads – one road will lead me to no family doctor while the other road could prevent that by implementing Dr. Philpott’s ideas. Standing at the crossroads scares me.
It scares me because my fellow Ontarians and I risk losing the preventive screening we need to lead healthy lives, increasing our risk of dying prematurely. I’ve read the reports and heard the statistics. I know that more of us will get sick without family doctors to care for us, but I didn’t consider how many of us could die. This is Canada. We have universal health coverage. Or do we?
Universal Health Coverage and Health Homes
Dr. Philpott advocates for a system where everyone, regardless of their socioeconomic status, has access to necessary health services without suffering financial hardship. Dr. Philpott underscored that universal health coverage is not just a moral imperative, but a practical necessity for sustainable development and global stability. She emphasized the critical role of social determinants in shaping health outcomes, arguing that addressing inequities in income, education, employment, and living conditions is essential for achieving health for all. Her insights highlight the need for policies that go beyond health-care delivery to address the broader socio-economic factors that impact health.
Dr. Philpott outlined her vision for health for all in her proposal for “health homes” for the 4.4 million Ontarians who will find themselves without a family doctor. She defines a health home as a team of health-care professionals who could provide comprehensive, patient-centred, and coordinated care in communities, particularly for individuals with chronic conditions or complex health-care needs, many of whom are part of, or soon will be, one of the 4.4 million Ontarians looking for care. By ‘comprehensive’, she means integrating primary, behavioural, and social health services into a single, cohesive model to improve health outcomes and enhance the patient experience.
According to Dr. Philpott, we need to add 250 health homes to our health-care infrastructure to close the gap in primary care access in the next 10 years. Health homes will need workforce training and efficient health information systems that can integrate and share patient data to become digitally optimized. This work must start NOW.
What Will 250 Health Homes Cost?
As a taxpayer, I braced for impact when Dr. Philpott discussed the cost of the 250 health homes. When she said they would cost $2 billion, I gasped. ONLY $2 billion? Dr. Philpott put the cost into perspective. $2 billion is about the same as the annual operating budget for Hamilton Health Sciences or The Ottawa Hospital, money they receive every year. Dr. Philpott proposes the same amount be spent on health homes over 10 years. Seems like a good investment to me. Can we, as a province, afford it? We can’t afford NOT to do it. Some areas of the province, like Kingston and Hamilton, are already thinking of creative solutions to provide access to family doctors in the “primary care deserts”.
Health homes can lead to cost savings for both patients and the health-care system. They have the potential to reduce hospital admissions, emergency room visits, and repetitive services. I hope they also attract more doctors to primary care. The result of not funding health homes would be costlier to our health-care system in terms of worse health outcomes for me and my fellow soon-to-be abandoned-by-the-primary-care-sector Ontarians, including the worst outcome of all – death. I’m not ready for that. I like to think I still have plenty of good years ahead of me.
Innovation and Technology
I devoured Dr. Philpott’s book. Putting my OntarioMD hat back on, I was happy to see that she included technology as part of the solution to implement her ideas. Embracing innovation is another cornerstone of Dr. Philpott’s vision and she joins the call for patient access to their medical records. She discusses how advancements in medical technology, digital health, and telemedicine can revolutionize health-care delivery and make it more accessible. However, she also cautions about the ethical considerations and the digital divide that technology can exacerbate. Technology evolves quickly and we need to consider these factors for Ontario’s doctors.
Conclusion
I’m inspired by Dr. Philpott’s hopeful and practical approach to achieving health for all. I like the idea of a health home where I can get the care I need in my community. Health homes represent a promising model for improving the quality and coordination of care, particularly for individuals with complex health-care needs. By focusing on comprehensive, patient-centred, and integrated care, health homes can enhance health outcomes, improve patient experiences, and reduce health-care costs. The successful implementation of health homes requires overcoming challenges related to funding, workforce training, data integration, and patient engagement. I hope we can overcome these challenges to avoid the even greater challenge of 4.4 million Ontarians without primary care.
Dr. Philpott’s vision is grounded in compassion, evidence-based policy, and a deep understanding of the complexities of health and health care. On behalf of patients at risk of losing their family doctors, I hope her call to action for policymakers, health-care professionals, and the public is heard.
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