One word, KABOOM!!! What a game changer it has been in delivering patient-centred, relational and longitudinal care!
I have read that “the fax” is an antiquated means of communication, but in community Medicine it still appears to be a cornerstone of care. I find it helpful because you can blend electronic and good old fashioned pen and paper to a message.
With all of the COVID-19 restrictions and safety protocols, the best thing about e-Faxing is that you can fax a prescription, consult letter, medical imaging or laboratory requisition right from the EMR (Electronic Medical Record) with just 2 clicks! Look Ma, no paper! ;D
Thanks for this Dr. W and P! You have to name it to tame it! As a full service Family Doctor for over 20 years I have seen the game change from "relational" longitudinal Family Medicine to a system that rewards transactional and corporate care.🙁 #blueskyfamilymedicine@BCCFPhttps://t.co/hzfGBbBxDt
As noted in the Tweet… corporate care is replacing good old fashioned (which is evidence-based effective) relational, longitudinal Family Medicine because the system rewards episodic and transactional medicine. 😦
episodic + transactional medicine = corporate care
Corporate care is more about the organization’s needs rather than good, holistic patient care… it is NOT patient-centred <mic drop>.
This blog has been a beacon of hope for the return of relational care of patients and families, but there are other powers in play that have not helped this worthy, world healing cause.
The 5 core arms of care for community Family Medicine in 2021 are: Urgent Care, Mental Health & Addiction Medicine, Preventive Medicine, Social Determinants, Occupational & Rehabilitation Medicine and Palliative & End of Life Care
It’s finally here!
Special thanks and many truckloads of ice cream sandwiches to UBC Family Practice resident,Ryan Danroth! His countless hours helping create this graphic will not be forgotten!
Ryan who? 😉
This is what we do, everyday!
This is a Family Doctor’s scope of practice… it is an honour and privilege to treat and help heal families! This is a blueprint for helping heal a planet! The mantle of Global Health and Environmental Health & Sustainability has been picked up by Family Medicine!
“Healthy planet, healthy people.”
Also my experience as Family Doctor Lead of the Snuneymuxw Family Doctor Home Visit program during the pandemic has given me such respect and an ever-growing education with Indigenous Health (Huy ch q’u, CP and community!). The future is bright with new Family Doctor positions coming to the Health Centre soon!
Indigenous Medicine Wheel
In Family Medicine, one takes a holisitic physical, mental, emotional and spiritual approach to healing and helping (Triangle of Health and Cognitive Behavioural Therapy (CBT) are conventional approaches that help too). The Indigenous Medicine Wheel and its 4 colours is a wonderful reminder of the way!
At this time of sub-specialization, diffusion of responsibility and dilution of care (can you say corporate care?)… isn’t it nice to know that your friendly, neighbourhood Family Doctor has you and your family’s back 24/7.
The Family Doctor dyad (thank you SdS and JS!) and/or Family Doctor-Nurse dyad (thank you CP and DI!) are rocket fuel for healthy and holistic physical, mental, emotional and spiritual care! When you can add Allied Health like Social Work (thank you JJ and JS!) then the social determinants of health and care can be healed! ;D
Relational continuity with a Family Doctor for your life journey is a key ingredient for making Canadians “unsick.”
It’s been some time since our last entry… not to say that the building of Blue Sky Family Medicine ever really stops or slows, but we have been fighting a virus and creating a virtual Lifestyle Medicine clinic with a young colleague (thanks JS!) in the meantime!
Quit Smoking 4 Good is another step to integrate the ever important Preventive Medicine focus in everything that we do in Family Medicine.
In January, we also had our annual Blue Sky Medicine TRIZ Exercise (see https://blueskyfamilymedicine.family.blog/2020/06/28/the-future-is-bright-for-blue-sky-family-medicine/) with our very savvy R1 Family Medicine residents (thanks team!) and we were joined by a very wise, younger colleague (SC) out in practice for the past few years and as always, it was magic! All of the answers on how to build a better primary care system and healthier planet are right here!
Enough said for now… just wanted to check in and post and also celebrate that the blog is now 1 year old! What a year it has been! 😉
Peace and health to the planet and galaxy in 2021!
Recently in hospital, we helped a 38 year old woman admitted with intractable back pain and unwellness. She was admitted by the Emergency Room physician with said diagnosis. Despite treatments, her symptoms did not improve so further testing was done (bloodwork and scans). She had a significantly elevated C reactive protein so there was concern of infection. Infectious Disease was consulted by a colleague covering who suggested more testing (blood cultures). Then the patient started developing swelling of her right arm so Internal Medicine was consulted because of the concern of DVT or other pathology. Blood cultures were negative and ultrasound was negative as well. The joint fluid was aspirated by a Proceduralist which showed numerous white blood cells, Gram stain negative and no crystals. Lastly, a Rheumatologist was consulted to help further diagnose and treat this patient. At the same time with all of the above occurring during COVID-19 hospital visiting restrictions (patient’s husband and children could not visit her), she was having increasing anxiety and low mood because of the above medical issues, lack of improvement in her health (she had been in hospital over a week) and disconnection from her family.
As her Family Doctor, we were able to connect, support and help her during this trying time in her life. That’s what makes my job so fun and fulfilling! As a generalist (who is mindful of Family), I have the honour of helping patients and their families heal with science, compassion and relationship.
As noted, we need specialists and their amazing work and care, but in the end, it is the holistic approach which heals patient (and their family).
This word cloud graphic was created to help give an overview of what will be practiced and perfected in the Centre. Family Medicine is a holistic art and science to help heal. Now more than ever, more of this type of medicine is needed.
This past week, I had the honour and pleasure of chatting with five other most excellent Family Medicine innovators (thank you SB, SF, MP, TM and MM!)!
The brainstorming and collaboration continue… as we figure out how to build this cool and exciting concept clinic (maybe virtual?)!
2020 has been such a very interesting year… we began this blog and journey to build something better for Family Medicine. As a Family Doctor for over 20 years, the patented office visit has not changed much over the years except for the addition of the EMR (Electronic Medical Record) system.
And then that puny virus came along… which has turned the world upside down, but at the same time it has helped us all create and innovate the art and science of Family Medicine. There has been more positive change in what we do in the office and in the community now more than ever! It has given some much needed time and space to reflect on how and where we need to go in Family Medicine to help heal our patients and the world.
In my quest of learning (can you say lifelong? ;D), I recently read this book to try and help understand why and how we all think.
It was enlightening and a bit scary at the same time. It helped inspire the creating of the Centre for Excellence in Family Medicine. Thank you Dr. Groopman!
I do not want to propagate an us versus them type of hierarchy or division, but with recent events from certain former Presidents and people around the globe, it begins to shed more light on what drives certain behaviours and collective beliefs: science and consideration/humility versus non-science and self-serving/arrogance.
The Dunning-KrugerEffect
This graph represents the Dunning-Kruger Effect. When a little bit of knowledge is dangerous and can give a person a false sense of confidence even arrogance like a certain (former) President T. Even experts don’t know it all and hence there still exists a degree of humility and limitation in what is known.
As a Family Doctor for over 25 years in practice (and still practicing!), I still don’t know what I don’t know, you know? 😉
One of the aims of a physician is Lifelong Learning and Reflective Competence each and every day. When helping and healing patients, asking key questions like: “What went well?,” “What was challenging?,” and “What is needed to help and heal better in the future (more knowledge or resources)?”
“It is still very much an art, a guild, where you are an apprentice and work with a master craftsman.”
How Doctors Think by Jerome Groopman, MD
I have observed, our younger Family Physician residents and early career physicians struggling in practice because only after a short 2 year residency, they are launched into the Universe without the support and further “apprenticing” needed to learn the subtle art of Family Medicine.
The pandemic has been helpful because we have had the honour and privilege of having a number of our recent UBC Family Medicine graduates stay around town and continue to hone their skills as “master craftspeople.” As they learn and grow as clinicians, I have been inspired and have learned so much from them on what it takes to become a Family Doctor. Thank you, young Doctors… the future is bright!
These concepts and principles continue to help us shape the Centre of Excellence in Family Medicine in Nanaimo.
Blue Sky Family Medicine 