Could family health teams save family medicine?
Published Sunday, April 3, 2011 10:06PM EDT
The ‘family health team' model appears to offer a solution to the problems of the chronic shortage of family doctors and the challenges of managing multiple chronic diseases new research suggests.
In an article recently published in the Annals of Family Medicine, an Ontario doctor and his American colleague are singing the praises of the model.
In family health teams:
- Groups of family doctors work in clinics together, alongside other health specialists.
- The specialists are on site and include dieticians, social workers, psychologists and pharmacists.
- The clinics are often open during evening hours and offer walk-in services on the weekends.
One such clinic has been operating in Peterborough Ont. since 2006. Since it opened, four more family health teams have opened in Peterborough, providing care to more than 25,000 patients who had previously been without a family doctor.
As well, the number of emergency room visits in the city has dropped by 15,000 per year, and 16 new family doctors have come to our community to join the family health teams.
Patients of the Peterborough Family Health Team clinic seem to like the form of care, calling it a kind of one-stop shopping.
"You know that when you are here, everything is going to be addressed," patient Carol Florence told CTV.
Dr. Don Harterre, the physician lead at the clinic, says he feels the clinic has shown that the model works.
"I think what we've seen is the physicians are happier, the health professionals with whom they work are happier, and the patients are not only happier but are really receiving better medical care," he says.
The doctors are paid though a salary and incentive bonuses, not through a fee-for-service model, so there is less need for doctors to rush through visits, and more incentive to ensure that each patient's different health needs are met.
Not only are the doctors more relaxed, they have the ability to earn more money than family doctors who work alone.
In their study, Dr. Walter Rosser of Queen's University in Kingston, Ont., and Dr. Jack Colwill of the University of Missouri, report that the average net income of a physician with 1,400 patients was $180,000 in 2004, after expenses. That annual income rose to $250,000 for physicians in Family Health Teams.
Rosser explained that the model can lead to cost savings at the hospital level as well, because patients tend to access care at the FHT facility on weekends and evenings, rather than go to more expensive hospital emergency departments.
There are also hopes that the model will lead to further cost savings due to preventive care, by allowing patients' multiple health needs to be addressed at once.
Rosser and Colwill say family health teams are effective and efficient and a model that the U.S. should consider as it faces the problem of adding 40 million people to its health care system if President Obama's health care reforms are passed.
There are now 200 of these family health teams in Ontario, tending to some 3 million people, with similar projects underway in B.C. and Alberta.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip