Changing the face of family medicine in Ontario

Date: Sept. 27, 1999
Time: 3:35 pm

The meeting, held by the Ontario College of Family Physicians (OCFP) recently in Toronto, brought together experts from the Ontario Medical Association, the Registered Nurses Association of Ontario, The Ontario Hospital Association and the Ministry of Health to discuss the recently-released OCFP paper proposing a primary care system emphasizing prevention and treatment, and a multidisciplinary group-practice team that offers round-the-clock service.

As a result of the group discussions, the OCFP will prepare 2 discussion papers to clarify implementation questions concerning nurse practitioner-physician collaboration, and doctor accountability in a blended funding model. The final version of the paper will be presented at the college's annual meeting Nov. 18.

"Some ideas are new and possibly revolutionary, but they need to be assessed and to evolve," said OCFP president, Dr. Walter Rosser. "It's ongoing work that will take at least 5 years to get in place."

The OCFP plan proposes that patients be registered with a single family practice of between 7 and 30 physicians, plus nurse practitioners and other health professionals such as physiotherapists. The professionals in a practice wouldn't necessarily all be in a single building, but would be linked electronically into a virtual group to serve the same patient population.

Instead of paying doctors a fee for each service they perform, the college advocates a new "blended" payment that incorporates a base salary, overhead costs, incentives for providing needed services and a payment based on the amount of work done. Presently, 92% of Ontario's 12 000 FPs receive fee-for-service payments; the college represents half these physicians.

While the OCFP plan was under scrutiny, the Ontario Ministry of Health announced it was expanding its primary care reform to include Thunder Bay, Ottawa and Parry Sound. More than 200 family physicians at 7 sites are currently part of the province's primary care reform project.

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