Hospital staff and paramedics are regularly trained in how to handle a public health crisis, but new Canadian research finds that many family doctors don’t feel anywhere near as prepared.

Nicole Kain, a PhD candidate in Public Health Sciences at the University of Alberta, interviewed 16 family doctors who had worked through a public health crisis. Some of them had seen infectious disease outbreaks, such as the H1N1 flu, while others recounted natural disasters that made doing their jobs challenging.

For example, she interviewed several doctors who had worked through the Alberta floods of 2013. Many of them found their own offices or clinics flooded, which made their work challenging. Others talked about forest fires that caused huge problems for their patients with breathing problems.

“What was interesting was that many docs talked about climate-related events that became public health events for them in their practice,” Kain told CTVNews.ca in a phone interview.

Kain says hospitals and other institutions often have disaster management plans for dealing with sudden natural events. But family physicians are mostly left to figure out how to handle these crises on their own.

“There’s always a focus on emergency services and ERs and ICUs, which of course are important. But I think it’s also important to include family physicians in planning for these crises because they play a very important role in disaster response,” she said.

Kain is in Toronto to present her findings at Public Health 2016, the annual Canadian Public Health Association conference.

She says climate change is leading to more severe natural disasters such as flooding, forest fires and smog days. While these events affect all Canadians, they tend to have the most negative impact on the most vulnerable: the elderly, those with low-incomes, and those with chronic diseases.

Because family doctors tend to be the first point of contact for these patients, Kain says it’s important they are trained in what to do during these crises so they can help their patients.

“Family physicians are among those who we trust for accurate information during a public health crisis, so I thought it was important to learn how family phsyicians could work together with government and public health agencies,” she said.

Kain would like to see family doctors go through the same kind of drills and mock scenarios that hospitals practise, to ensure they know who to turn to in during an emergency.

As well, Kain would like to see:

  • Real-time apps for doctors that could track air quality during a forest fire or bad smog season. A family doctor working in Toronto made that suggestion, who noted the technology already exists for such an app; it’s just a matter of getting it into the hands of doctors.
  • A way to have live updating of electronic medical records to alert doctors of current air quality reports and climate events. That way, doctors could contact their patients with severe breathing difficulties to tell them how to stay safe.
  • Real-time GPS that would assist during floods and hurricanes so doctors could know which roads were closed, and find out where the alternate care centres and shelters were, to better direct their patients.

Kain admits family medicine “isn’t traditionally where a lot of new and exciting innovation takes place.”

But she says it’s clear from her research that family physicians’ perceptions of what constitutes a “public health crisis” is changing, so their role in these disasters should evolve too.