Physician Burnout, Interrupted | NEJM https://t.co/YHihZtTEEm
— Dr Jessica Otte, CCFP 🇨🇦 (@LessIsMoreMed) October 30, 2020
All the more reason for @DoctorsOfBC policy work on non-clinical burdens of care and understanding the cumulative impact of these mounting tasks; let's bring back #joy in medicine CC Mr Joy: @drpoteryko
As Dr. Otte alludes to with this NEJM article… the joy of being a Family Doctor has been challenging over the past number of years due to bureaucratic and electronic (even political) creep.
Have no fear, Blue Sky Family Medicine and the Centre for Excellence in Family Medicine has come to save the way. 😉
Peace!
https://bcmj.org/blog/how-make-good-doctor
As we continue to do the preliminary and necessary work to create the Centre for Excellence in Family Medicine in Nanaimo, I stumbled upon this article and pondered.
Words like: caring, concerned, competent, compassionate, creative, communicative, calm, comforter, conscientious, compliant, cooperative, cultivated (C wins!)… anything else? Please leave your words and thoughts in the comments.
Unfortunately, the image and identity of Family Medicine has been amiss in the past few years… it’s no one’s fault… I think that we all have been a little distracted taking care of our patients as the world continues to become more complex and complicated. Can you say global pandemic? ;D
This quote always inspires and grounds me.
Having said that, it is important to go back to basics and understand who, what, why and how we are and need to be to help heal the world.
Stay tuned!
Thanks Dr. M!🙏 Nanaimo has 20 Family Doctors in town looking for work… makes you go hmmmmm! #blueskyclinic #betternanaimo #familydoctorstakecareoffamilies https://t.co/J47uM0JS1T
— Dr. Derek "#YouAreNotAlone" Poteryko (@drpoteryko) October 16, 2020
Blue Sky Family Medicine is an ideal… it is the way Family Medicine must evolve and improve in order to help and heal our communities and the world.
Recently, a clinic named Blue Sky Medical opened in Duncan, B.C.
We wish them every success!
With that, since 2016, we have been evolving and improving the concepts of Blue Sky Family Medicine in Nanaimo and presented our research findings to the province in 2018.
Not that there is any issue with sharing the name Blue Sky (which is a cool name)! ;D
For the record, the clinics are not affiliated… what we are creating here in Nanaimo and with this blog… is a Centre for Excellence in Family Medicine.
<mike drop>
Peace!
In a complex, complicated and ailing healthcare system, these two words sum up the cure.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042583/
And as the pandemic continues on, I want to say that as a Full Service Community Family Doctor who has a defined patient population… it has been a joy, honour and privilege taking care of my patients at this time (no burnout here).
Family Doctors take care of families.
I am entrusted with helping in some families, 4 generations, which resonate with my values as a caregiver and scientist. My job is easy! I will give a shout out to the B.C. Ministry of Health (dare I? 😉 ) for their billing code support for telemedicine!
There is much anxiety regarding the virus and the future and through a trusting, longitudinal relationship we are helping allay some of those fears and helping heal (many times using telemedicine, see https://blueskyfamilymedicine.family.blog/2020/04/26/covid-19-is-helping-improve-canadian-and-global-health/).
Just hoping that recent governmental directions of de-emphasizing Family Medicine and not supporting community Family Doctors in B.C. that we don’t follow our American cousins.
https://www.newyorker.com/science/medical-dispatch/americas-looming-primary-care-crisis
“The health-care system, Berwick said, was falling into the same trap: clinging to a sometimes burdensome tool, no matter the circumstances. “Our Pulaski,” he argued, “is the encounter—the visit.” A better health-care system could only be built if “scientists, professionals, patients, payers, and the health-care workforce” agreed “that the product we choose to make is not visits. Our product is healing relationships.”
Thanks Dr. Berwick! Words to live and heal by!
Peace!
If you Google “blue sky clinic Poteryko,” you will see that way back in 2018, we (with two young, bright Family Doctors) presented the fundamental concepts of the Blue Sky Family Medicine clinic (and the Primary Care Plus model of care with compartmentalization of roles (hospital, community/triage and clinic) and triad-care practices, see blog post Nanaimo Has Too Many Family Physicians…) to the rest of the province via a GPSC-sponsored webinar. We chatted about the importance of Relational Medicine versus Transactional Medicine and many other ways to make Family Medicine thrive in community again.
https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1118
Some of the groundwork came from a research paper written by another two bright, young UBC Family Practice residents (Chris Yeker and Jesse Wolfe) about the Perceived Barriers to Full-Service Family Practice: A Survey of Family Practice Residents (we watched in awe as Principal Investigator or PI).
And lastly, every January during a UBC Family Medicine Residency Behavioural Medicine teaching session we do a Russian engineering exercise called a TRIZ with the first year (R1) Family Practice residents. It’s a great way to get a healthier perspective and find solutions for an ailing primary care and healthcare system. The residents teach me! We start with the Black Sky (all the things that don’t and won’t work in the current medical system) and then move on to a Blue and Better Sky with realistic and specific solutions. It is always so fun and inspiring.
The sad truth is that this concept clinic was ready to help and heal the community way back in 2018. It has had little support from government and local bureaucratic organizations. Some have said that this innovative, creative and holistic approach to Family Medicine is “ahead of the curve.”
Let us know when the curve catches up…
Peace.
When it comes to team-based care and Family Medicine, Social Workers sometimes make the biggest difference for a patient to go from surviving to thriving!
As said, we our honoured and privileged as a Family Doctor to work and collaborate with the many other amazing allied health team members like MOA’s, RN’s, LPN’s and NP’s to name a few (see #iamccfp blogpost).
This slide always humbles me and when I work and witness what Social Workers do everyday with our patients and how they can improve the patients’ Social Determinants of Health or #SDOH… it will make you a believer too!
It’s primary care rocket fuel in the community when a Family Doctor does a Home Visit or Outreach with a Social Worker (or RN)! You can really start helping a person’s Health (capital H), big time!
With all that is happening in the world today and the social inequity that exists, I think it’s time for the Blue Sky Family Medicine movement to become a reality with team-based Family Medicine care for Nanaimo (and beyond).
Let's just add that Family Physicians have a role to play in addressing systemic racism in Canada AND the world!❤️🌍 Think global, act local. #thestatusquomustgo #betternanaimo #blueskyfamilymedicine @FamilydoctorsBC @KJFMartin @drcadesky @eyazganoglu @BCCFP https://t.co/NmhbO00D8J
— Dr. Derek "#KidsRule" Poteryko (@drpoteryko) June 2, 2020
Remember, you cannot have world peace without internal peace.
Think global, act local.
This past week, I had the honour and privilege to do a Home Visit for an Elder patient in my practice and her family in community. She was becoming more confused at home and required an assessment and review. I was also able to visit with her daughter and grand daughter (patients in the practice) at the same time! One can always gets so much meaningful and helpful information when you visit someone at home in terms of their Activities of Daily Liviing (ADL), housing situation, food security and even social supports (which includes quality of life).
It is also a great time to check in and strengthen the relationships you have with the rest of the family (remember that Family Doctors help families! see blog post Family Doctors = GP who specializes in family). I am honoured that I take care of 3 generations of this family.
During this global pandemic, we were able to keep my patient safe from COVID-19 with regards to practicing safe precautions with my visit (masking and good hand hygiene) and in the end sending her to a local lab for some much needed blood testing to help make a diagnosis and then prescribe the appropriate treatment without “an escalation in care.”
Unfortunately, many times for people who do not have relational continuity with a Family Doctor and therefore do not get timely access to health and care at home in community (because of frailty and reduction in mobility, they are unable to visit the Doctor at the office). Without the early help, symptoms can escalate and then Emergency Health Services (EHS) must be called with a trip to Emergency and sometimes admission to hospital which many times could have been been avoided (with early interventions).
This is a great TED talk on how the home can be the best place to heal:
https://www.youtube.com/watch?v=zamvnyBB-SU
The future is bright for relational Family Medicine!
Happy Sunday afternoon! With the advent of the 14078, I can help (and heal) my Family Practice patients via e-mail and/or text (thank you B.C. MSP and GPSC!)!
In the span of a few minutes, I have connected with 4 patients about a skin infection, Mental Health issues (anxiety, depression and eating disorder), heart failure and pediatric behaviour concern.
Relationships heal…
This recent editorial in the Globe and Mail speaks volumes on what has been missing in our pre-COVID primary care healthcare system in Nanaimo, B.C. and Canada.
Not to be labour the point, but in 2017, Nanaimo had a comprehensive and cost effective solution to help then (see March 2020 blogpost Nanaimo has too many Family Physicians…).
Fast forward to 2020, Blue Sky Family Medicine is a key ingredient going forward in a post-COVID world to help change the narrative and help the health of an entire planet. Relational Continuity with a Family Doctor (and team who help heal physical, mental, spiritual and socioeconomic health) in a hub with a comprehensive coverage network (hospital to home) really is not rocket science. Unfortunately, the pre-COVID bureaucratic and governmental systems in place could not get the job done in a timely nor functional fashion.
Watching my colleagues and only key leaders plan and innovate for the COVID pandemic has been refreshing and inspiring because without the bureaucracy and governmental systems getting in the way… stuff got done!
My only hope is when things begin to settle that we are listening and learn from these essential lessons.
Peace.
Blue Sky Family Medicine