every day of the week,
including weekends,
doctors need to log into the EMR,
and check and see if new results are there
In #BCPrimaryCare, many doctors do this on VACATION, because of how much work it is, and how hard it is to find vacation coverage (=locum)
Oh, @AnnGrahamWalker can’t recall if I sent you this thread? Summarizing one of our recent studies that describes actual patterns in #BCprimarycare
I wrote another 🧵
about the
nuts and bolts of
how the
“primary care sausage”
gets made
This one,
how I make
referrals to specialists
&/or
get extra advice.
#bcprimarycare
@BCFamilyDoctors @dr_rdosanjh
I am a generalist,
full-service family doctor,
working in a clinic
that provides
longitudinal primary care,
and I referred
a few patients
to specialists
this week...
here's how and why that happens 🧵 1/9
(#BCPrimaryCare)
This tweet seemed to hit home to many people💥
Going to talk to
@CBCGloria on
@CBCOnTheCoast at
~4:10 pm today
About the #BCPrimaryCare view of Omicron,
& why I 💕💉(=LOVE COVID VACCINES)
for kids 5-11
(as well as all other age groups)
&masks
&isolation when sick
I did a 🧵about being on all for a family medicine clinic.
It helps explains the 2 decades long #FamilyDoctorShortage
Which is not really a shortage, but rather an antiquated care model dying a natural death, & inadequate alternatives emerging. #bcprimarycare @BCFamilyDoctors
I am on call for my primary care clinic this week...
What does that mean?
A 🧵 about how
our fee for service (soon to be "group contract") clinic
of 16 clinicians, ~15,000 patients
delivers afterhours #BCPrimaryCare
@BCFamilyDoctors
I was on call last week, primary care call, so not really that heavy, compared to my hospital-based colleagues.
But the extra alertness, anticipation & emotional labour, on top of doing everything else... it was too much.
I am ...crispy
#BCPrimaryCare is not sustainable.
Also, just finishing my notes now.
4.5 hours after seeing last patient.
I am tired.
#BCPrimaryCare
MYSTERY OF TIME AND SPACE IN PRIMARY CARE:
Why do clinic notes take 3-4x longer to complete the day after clinic visit takes place?
[I make EVERY HUMAN effort to finish a note at the end of an encounter but that is .... not always possible]
#FamilyDoctorShortage
#BCPrimarycare
I think the fax machine + fee for service are best friends in #BCPrimaryCare.
💣Both have important, valuable yet... historic uses.
💣Both need to move on & let new "technology" lead us to the future.
@DoctorsOfBC @BCFamilyDoctors
(cc: @crecsky)
Adding "team members" to #BCprimarycare
to expand access
to community-based primary care,
without building
teamwork skills at the clinic level
#FamilyDoctorShortage
https://x.com/i/status/1447760752035594242
(have so many more #FamilyDoctorShortage uses for this meme)
Trying to get more family doctors
to do/stay in
community-based primary care
by adding new "fee for service" fee codes
#BCPrimaryCare
https://x.com/i/status/1447760752035594242
Thx @FamPhysCan
Wish we had evidence-based models of practice in #BCPrimaryCare to support continuity of care.
Unlikely to address the #familydoctorshortage until we get them.
@BCFamilyDoctors
Why does continuity of care […]matter? https://www.cfp.ca/content/67/9/679
First day back in clinic for awhile.
Guess how many passwords I need to get set up for the day, secure email, emr, reference websites, etc.
Six. That’s how many.
Guess how many I remembered?
😬
#BCPrimaryCare
#medtwitter
Happy to speak to Brandon Barrett @PiqueNews about the ongoing #FamilyDoctorShortage & #BCPrimaryCare (and what is popping up to serve the gaps we have now)
www.piquenewsmagazine.com/local-news/new-mobile-me...
It’s 4:30pm on a Friday clinic day.
Time to turn on my designated “catching up on ehr patient notes” weekend starter playlist.
#bcprimarycare
The Parkade Vaccine Clinic crew!
#VaccinesWork
#familydocsrock
#BCPrimaryCare
@UBCFamPractice
@VCHhealthcare
1/14
🇨🇦#FamilyDoctorShortage?
Lazy Millennials ... OR… ?
A TWEETORIAL of our new paper
http://doi.org/10.1186/s12960-020-00508-5
@SpringerOpen @UBCMedicine @PHCResearch @CHEOSNews @SFU_FHS @LindsayKHedden @SetarehBani @NardiaStrydom @DrRitaMc
#BCPrimaryCare
@adriandix...
The story of our “underground” influenza vaccine clinic that is getting shut down for breaching a parking bylaw.
But we have 30 days to comply = 30 days of vaccinating.
#BCPrimaryCare
@DoctorsOfBC @cbcnewsbc @VCHhealthcare @CDCofBC
@UBCFamPractice...
Happy to speak to @cindyeharnett @timescolonist about the #FamilyDoctorShortage in #BCPrimaryCare
About what the evidence tells us we need to fix the problem.
@BCFamilyDoctors...
HUGE NEWS IN #BCPrimaryCare
💥new💥
clinic-based
physician remuneration
model,
(w ACG complexity modifier!!) to
promote
team based care and
improve patient access.
🥳
@DrKathleenRoss1
@BCFamilyDoctors @BCCFP @UBCISU @DoctorsOfBC
Part report, part ethnography, this is the story of the crisis state in #BCprimarycare
Covid exposed how fragile our whole system was. Now it is crumbling in front of our very eyes.
Can it be saved?
@BCFamilyDoctors
@DoctorsOfBC
@BCCFP...
Super pleased to share this new study exploring the reasons for the #BCPrimaryCare Family Doctor shortage.
@SpringerOpen @BioMedCentral @LindsayKHedden @SetarehBani @NardiaStrydom
(spoiler: family doctors work in many roles& rarely as FTE "classic...
Corporations Want Your Health Records.
@TheTyee
Am I wrong?🧐
“It’s much more likely that corporations see those possibilities-and the possibility of immense profit-as the reason to get into primary care, McCracken said.”
#bcprimarycare
...
Why Are Corporations Moving into Health Care?
Doctors Say It’s the System’s Fault
#bcprimarycare
@drmzeineddin
@BCFamilyDoctors
@BCCFP
@DoctorsOfBC
@TheTyee @A_MacLeod_Tyee thetyee.ca/News/2020/09/08/Corporat...
.@BCFamilyDoctors and @DoctorsOfBC how do you do “stress first aid” w colleagues in a fee for service, self-employed model?
How do you offload work to team members, if you have no team?
Who will assume you won’t ask for help &come &check on you
#BCPrimaryCare, heal thyself?
Appreciate
this dissection
of the
FLAWS
with
for-profit,
episodic/fragmented
in the
“mobile health care app touted by the Alberta government”
@macleans
@JillianRatti
@DanyaalRaza
@DoctorsOfBC
#BCPrimaryCare...
This is good news:
billing changes for #BCprimarycare docs using telehealth and the phone. www.doctorsofbc.ca/news/covid-19-temporary-...
11/ would love to hear from other primary care clinics what they are doing!
#COVID19 #bcprimarycare
