Yesterday, the Ontario Legislature passed the Patients First Act — purported to improve connections among local care providers, streamline and reduce administration of the health system, and enhance accountability to better ensure people in Ontario have access to care when they need it.
There has been significant ongoing opposition to the bill from individual doctors as well as physician groups and associations, most notably the Ontario Medical Association.
Much of the concern with the bill is not about these laudable goals or objectives, but more about the strategy for implementation, which many read as leading to significant bureaucratic bloat and healthcare administration growth while diverting much-needed funding from front-line healthcare providers. Much of this contention is also clearly linked to the lack of dialogue between doctors and the Ministry of Health due to a long-standing contract dispute, in its 3rd year without resolution.
In the lead-up to the passage of Bill 41, we simultaneously have seen calls that the healthcare system is broken, requires more funding and “needs to be fixed”, but also strong calls to reduce the same oversight, regulation, and levels of hierarchy in the system that this bill will introduce (especially given the recent Ontario Auditor General’s scathing report — watch for another blog post on this soon!).
With such a great philosophical divide, what are we as clinicians to do? We can wait for top-down changes and risk more broken promises or we can seek out the change our patients and practices need. As family doctors and founders of ConsultLoop, we’ve been trying to channel our frustrations into improving how clinics connect to each other during the referral process. Over the past 6 months, we’ve been building a network of like-minded doctors and clinics who want to do better. These family doctors share our vision of a better way to communicate with specialty clinics, a better way to find the right specialist for their patients, and better ways to include patients in the referral process. Similarly, the specialists we are working with want to offer better access and availability and be more responsive to the referring clinics around them.
Why does building this sort of “bettering” network matter? Because as doctors — whether we are actively advocating that Bill 41 be repealed, or are cautiously hoping for the Bill’s success — we do care and we do want to deliver the best care for the patients in front of us. But it can be difficult for individual clinicians to tackle the obstacles to good care that feel beyond the walls of our clinic or hospitals. By building from the expertise of our front-line colleagues, informed by experience, good judgement and concern for patient care, a shared purpose emerges through these networks that can begin to overcome these challenges.
It’s up to us as doctors to deliver meaningful, high-value care and to continue the drive both individually and as a profession to make things better. We aim for ConsultLoop to be a “feel-good” success of a bottom-up, physician-led grassroots initiative that fills in the gaps where government-led initiatives haven’t and are unlikely to succeed — by improving connections among providers, streamlining administrative processes, and enhancing accountability in the system.
Sounds a lot like putting patients first.