Re: A GP for Me: GPSC responds

Asking physicians to work harder, work longer hours, and take on more patients is not a solution to the current issues in primary care. That’s why the General Practice Services Committee (GPSC) and its funding partners, the Ministry of Health and BCMA, are working collaboratively on comprehensive programs to address patient needs. A GP for Me is one of the programs designed to strengthen primary care through enhancing the relationship patients have with a family physician. It isn’t operating in isolation. It will build on home, maternity, and mental health integration efforts; funding to improve capacity in the primary care system; and GPSC programs such as the Practice Support Program.

Three divisions of family practice—Prince George, Cowichan Valley, and White Rock–South Surrey—prototyped A GP for Me. Much of what they learned will be directly transferrable to the rest of the province. The original funding formula is not. The prototypes were funded at $20 per citizen, but the province-wide formula is not calculated per citizen. The $3.50 mentioned by Dr Grobbelaar was an early figure that was discarded after consultation with physicians. Building on the success of the prototypes, the GPSC realized that many communities that have a division of family practice have begun working with their health authorities and community partners on attachment-like work already, so they’re not starting from zero. 

Two levels of funding for A GP for Me were ultimately approved. The first provides $40 million to divisions of family practice over the next 3 years to begin the work of increasing primary care capacity locally. The second pro-vides $60.5 million for 2 years to individual family physician practices in the form of new fees, to recognize and sup-port the provision of longitudinal care. At a community level, divisions—working with partners in care—will develop a plan to improve the primary care system at the practice, local, and regional levels. The foundation for this will include initiatives like practice assessments and community surveys.

The goals of A GP for Me are to:
•    Confirm and strengthen the GP-patient continuous relationship, including better support for the needs of vulnerable patients.
•    Enable patients who want a family doctor to find one.
•    Increase the capacity of the primary health care system.

Can it work? As Dr Grobbelaar so eloquently put it, the three prototypes have already demonstrated that a comprehensive attachment strategy, with the same or less effort for the practising GP, can work. In White Rock-South Surrey it took about 2 years to go from a situation where no doctors were accepting new patients to being able to offer a family doctor to anyone in the community who wants one. That’s phenomenal. 

Clearly it can work. But it can’t work in isolation without the collaboration and participation of family physicians and—as the successful prototypes found—it can’t work without community partners, such as local health authorities, local governments, community organizations, and partnerships with patients. This multifaceted approach to patient attachment has not been tried before in a fee-for-service health care system. It’s pioneering, and it’s a journey. Many are eager to participate. Thousands of physicians have already billed Attachment fees and most divisions are already laying the groundwork for A GP for Me participation. 

The benefits of a strong primary care system and attachment to a regular care provider are proven. The GPSC, the Ministry of Health, and the BCMA are all committed to undertak-ing this journey with physicians. We know that togeth-er we can achieve powerful results for patients, physicians, and our health care partners who deliver primary care. 
—Shelley Ross, MD
—Kelly McQuillen
GPSC co-chairs