Dr Peter McPhedran
Clinical Lead Rural Wellington, WWLHIN
I’ve seen many changes in health care since I began to practice family medicine in 1980. At that time, ultrasounds were not widely available, CAT scans were in their infancy and available only to specialists, and there were no MRIs. We had only a small percentage of the drugs we have today. It may seem counterintuitive, but 30 years ago Groves Memorial Hospital had twice as many beds as it does today. Now, more patients are being treated on an outpatient basis, and are not being hospitalized for illnesses like pneumonia. As the health system has changed, it has been necessary for physicians to constantly update their knowledge to be better informed to care for their patients.
There has also been considerable progress in improving the quality of patient care. Notably, we are bringing a patient lens to the health system by having more patient representation on working groups and committees. This has improved communication between patients and providers. In 2014, I was involved in an advisory group to address the challenge that primary care physicians didn’t know when their patients were admitted to (or discharged from) the hospital. By mandating that the discharge summary be available to the primary care provider within 48 hours, we were able to improve a warm hand-off and patient care.
I am currently involved in a number of initiatives that will help address the pressure points in the health system. One of which has been the lack of services available for individuals with chronic pain. After three years of conversation and planning, on October 22, 2018, we opened a chronic pain clinic at Grand River Hospital – Freeport Campus. A second initiative addresses the lack of addiction services available for residents living in rural Wellington. Our aim is to coordinate services that are currently fragmented so people have better access to providers and the resources they need. A third initiative will enable the WWLHIN to have a real sense of the number of residents in Waterloo Wellington who don’t have a family doctor (without the requirement of needing to de-roster from another doctor). We’ll be better positioned to link these unattached residents to new physicians when they move into the community.
Mental health is one of the biggest challenges facing the health system. In rural Wellington, there are services for those individuals needing treatment for less severe problems. However, those who need the most intensive treatment services often wait for long periods of time. We’re working to optimize the current system which is challenging, in part, because funding for mental health services comes from different sources.
Another challenge is supporting patients with self-care and managing their own health care needs. We are doing a good job putting resources into educating patients about managing diabetes. We need to put resources into educating patients who have other chronic diseases, such as heart failure and COPD that along with diabetes are costly to the health system. Patients today are generally more aware of the impact they have on their health and are more open to education. Gone are the days when people had blind faith in their doctors. Today, they are more engaged and well versed in their illnesses.
When I began my family practice, I was interested in a full scope of practice with a rural bias. Today, that experience helps inform the work I am doing at the WWLHIN to improve health services for everyone in our region, including our rural residents who often have less access to services and resources.