Divisions of family practice are community-based groups of family physicians working together to achieve common health care goals. Divisions work collaboratively with community and health care partners to enhance local patient care and improve professional satisfaction for physicians.
Beginning in 2009 in three prototype communities, the Divisions of Family Practice initiative has expanded to include 35 divisions representing more than 230 communities, including a division that targets physicians in remote and rural areas of the province.
The Divisions of Family Practice initiative is funded by the General Practice Service Committee (GPSC), one of four joint committees that represent a partnership of the provincial government and Doctors of BC.
A decade ago, primary health care in BC was in decline. Family doctors were disillusioned and disengaged, and increasing numbers of medical students were opting out of family medicine. Recognizing a need for change, Doctors of BC and the provincial government embarked on a journey together to improve primary care. This process began in 2002, with the formation of the GPSC.
As a first step to improving patient care and physician satisfaction, the GPSC listened to the stories of over 1000 doctors across BC during a two-year consultation process. The message they heard was clear: doctors wanted to be valued, trained, supported, and compensated appropriately within the health care system. Responding to these needs meant finding new ways of empowering doctors to build relationships in their communities, promote leadership, and inspire health care change. A grassroots approach was needed, and the Divisions of Family Practice initiative enabled this.
Structure and funding
Divisions are community-based non-profit groups that bring family doctors together and provide the infrastructure to support them in addressing common needs and health care priorities in their regions.
Through their local division, physicians have been able to:
- Connect and share ideas.
- Overcome the obstacles to collegiality created by geography and busy work schedules.
- Come together to address common issues in their practices, organize educational events, discuss health issues faced by local residents, and make decisions about health care in their communities.
- Work with other health care stakeholders and government partners, and refine a framework for collaborative health care decision-making.
- Have a powerful voice, and, for the first time in many years, feel capable of influencing change.
Perhaps the greatest success of divisions has been in building relationships and fostering collaboration between physicians and other stakeholders within the health care system. Much of this collaboration happens through the Collaborative Services Committees (CSCs), which include representatives from divisions, regional health authorities, the GPSC, and Ministry of Health.
Through CSCs, these partners work collectively to identify and address local health care challenges, as well as to engage the broader community (e.g., representatives from municipalities, other nonprofits, and patients). This new collaborative landscape has revitalized interest in primary care, and helped to reverse the trend of physicians and students opting out of family practice. Divisions have also created a supportive physician work environment, helping to ensure that doctors don’t experience the kind of isolation they felt in the past.
Evolution of care
The expansion of the Divisions of Family Practice initiative is driven by the interest and commitment of family physicians. Divisions are engaged in both community-based projects and province-wide initiatives to meet the needs of specific patient populations and improve access to primary care.
In seven years, the Divisions of Family Practice initiative has become a cornerstone of BC’s primary health care system. In a field as large and complex as health care, the speed and growth of change that has been achieved through divisions is revolutionary.
With over 90% of family physicians in the province engaged in a division of family practice, this movement is shifting the culture of primary health care in British Columbia and supporting the next generation of family doctors to enter the health care system in an exciting environment of collaborative change.