Physicians need to be involved in hands-on business as well: Harterre
Friday, March 23, 2007 -- By Michelle Strutzenberger
Dr. Donald Harterre is encouraged to see the Central East Local Health Integration Network (LHIN) indicating an awareness of the importance of primary care in the future of the health-care. The CE LHIN is currently recruiting for a Primary Care Working Group (PCWG).
“As we go forward I think primary care providers become key members in the health delivery system, with the renewal of interest in primary care delivery in general,” says Harterre.
The mandate of the PCWG is to work in partnership with the Central East LHIN and its planning partners such as networks and collaboratives to implement a number of strategic activities from the LHIN’s Integrated Health Service Plan (IHSP).
These activities include, among others, providing expert advice on IHSP priorities involving primary care solutions, such as the development of strategies that will:
Provide ‘primary care’ to those without a physician
Improve family physician’s awareness of local, community-based health services
Build capacity and uptake for the use of e-health solutions
Develop tools that assist with the self-management of chronic conditions
Enhance capacity and uptake of interdisciplinary primary care teams
Harterre notes that there are two general ways that primary care physicians can be represented in the LHIN change agenda, first as advisory bodies to the LHIN, “which is important and I think we should avail ourselves of that opportunity,” he says.
“But I think more importantly I’d like to see primary physicians actually have the opportunity to really influence those various institutions and issues [that will be addressed], instead of just being an advisory to the LHIN,” says Harterre.
“I’d like to see primary care physicians having input into the hospitals, into the organizations that actually directing e-health, for example… to see primary care actually getting involved in the hands-on business as well.”
“I would hope the LHIN would encourage the involvement of primary care physicians in the institutions that the LHIN will be working with, such as hospitals, health units, access centres.”
Harterre says he believes there is an interest on the part of primary care physicians to be involved in all aspects of the health-care delivery system.
While it may not have been the case in the past, he says that “now with primary care reform, family medicine does have a collective voice. Primary care physicians have become important players and I think they need to collectively stand up to that recognition and contribute.”
Harterre is the lead physician for the Family Health Teams in Peterborough. Aspects of those teams correlate to the strategic objectives of the Central East LHIN’s IHSP.
The concept of the Family Health Teams (FHT) involves physicians working collaboratively with nurses, nutritionists, and other health-care workers to provide care. Harterre notes that Peterborough is on the forefront of this movement and most physicians are involved in the FHTs.
Plans are to provide access to primary care for patients without a family physician in the area. Harterre says that of the 25,000 persons without a family physician, the FHTs have managed to connect 7,000 to a doctor in the first year of operation.
“I think that’s pretty significant,” he says.
Future objectives include providing medical care through chronic disease and prevention management.
“To give you a capsule picture, with past medicine, when you got sick, you went to the doctor… so the doctor was sort of putting out fires all the time… In the future [health-care] will be much more proactive, we’ll be trying to seek out best practices, to find out different factors that have to be controlled to prevent people from getting sick in the first place.” He notes as an example, controlling cholesterol and so hopefully preventing heart disease, rather than waiting for the heart attack to occur.
“It can pay big dividends if we can prevent disease from occurring,” he says.
These are the issues that will be the emphasis in FHTs and Harterre says that primary care reform will be very much focused on these aspects of health-care as well.
“As such, primary care doctors will have to work not only with allied health professionals such as nurse practitioners and nurses, but also with specialists who obviously have expertise in their own area.”
As health-care moves toward “involving the whole community, the primary care physician becomes pivotal and becomes an important player,” a fact, he adds, that the LHIN appears to be recognizing.
Harterre is also a co-chair of the Chronic Disease Management and Prevention Steering Network for the Central East LHIN.
“I’ve recognized the emerging importance of the LHINs, so in Peterborough I, and we, have been very anxious to communicate with them and to cooperate with the whole LHIN organization.” He says he is certainly interested inadvancing the cause of primary care through future LHIN involvement.