Family doctors play growing role in Toronto health-care system: U of T report

Beyond common colds and flu, the number of patients visiting their family doctors for issues related to mental illness and chronic diseases such as diabetes and hypertension is on the rise, according to a new report on the state of family medicine in the Greater Toronto Area.

The recently released University of Toronto Family Medicine Report shows a wider variety of ailments are being treated by family doctors than in the past. Anxiety, for instance, is one of the top reasons for visits to family doctors in every age group, and the top reason for adult females. Chronic diseases – the greatest health challenge facing Canada and much of the world – are also increasingly managed by family doctors.

Using data from the de-identified electronic medical record data of nearly half-a-million patients, the report is the first evidence-based, comprehensive picture of the role of family doctors in our health-care system and provides new insights into the health and wellbeing of the citizens of Toronto and beyond.

“This report reinforces the findings of international studies which show that having family medicine as the basis of a country’s health-care system keeps people healthier, reduces costs and ensures more equitable access to care,” says Dr. Michael Kidd, chair of U of T’s department of family and community medicine and one of the authors of the report.

“As we start to roll out Ontario Health Teams, this report provides timely evidence and insights into the central role of family doctors, and the members of our teams, in our health-care system.”

Beyond the treatment of common illnesses, many family doctors in Ontario deliver babies, work in emergency departments, provide palliative and end of life care, participate in research and innovation and much more. The diversity of patients and ailments seen by family doctors is quickly changing as well.

“The data in this report confirmed a number of trends we are seeing in health care,” says Dr. Karen Tu, lead author of the report, a co-director of the University of Toronto Practice-based Research Network and a professor in the department of family and community medicine with a cross appointment at the Institute of Health Policy Management and Evaluation.

“Mental health and chronic diseases are being treated by family doctors far more frequently. We are also continuing to see high rates of smoking and obesity, so it’s key to find new ways to help family doctors treat and support patients with these concerns.”

The report also highlights areas of care where family doctors can play an even larger role. For instance, only 63 per cent of Indigenous people living in Toronto have a regular family doctor or nurse practitioner, compared to 90 per cent of the general population. The report also tackles issues like the lack of access to palliative care by marginalized populations in the Greater Toronto Area, the health concerns of refugees and what family doctors are doing to address the ongoing opioid crisis.

“Not everyone knows or appreciates the breadth of services family doctors provide and the value family medicine brings to our health-care system,” says Kidd.

“Family medicine provides the solution to overcrowded emergency departments, the challenge of hallway medicine in our hospitals, and the inequities we see in access to quality health-care services.

“This report highlights the importance of family medicine as the foundation of a successful health-care system and reinforces the need for further investment in primary care to ensure that quality health care is available to all Canadians.”