Transgender care has been identified as an emerging health care issue for family physicians and primary care providers. Recognizing the need to support physicians in the health care management of transgender patients in family practice, a number of divisions have undertaken projects to create sustainable solutions for ensuring transgender patients feel safe and confident in accessing care.
Through its ongoing work to attach patients to family doctors, Vancouver division became aware that there was only one GP in the region with the practice capacity and necessary skillset to take on transgender patients. To create a sustainable solution, the division looked at specific patient needs and the number of patients requiring care, and identified doctors who had come forward to help but who didn’t have the necessary skillset. The division then provided mentorship, training, networking, and resource opportunities for these GPs, all of which enabled five additional doctors to take on a cohort of transgender patients.
The Abbotsford division found that members were experiencing difficulty in sourcing information and resources for transgender patients and providing timely, accessible care. The division received funding from the Shared Care Committee to develop a pathway of services and resources for the Fraser East region (Langley to Boston Bar) for transgender-specific health care. The Provider Pathway will support physicians and other health professionals by providing options for involvement depending on their level of interest and knowledge, ranging from making effective referrals for their patients to continued co-management of patients with specialists. The Patient Pathway will support patients and their families in navigating services and resources. The project’s steering committee comprises division members, specialists, Fraser Health, Abbotsford Youth Health Clinic, Trans Care BC, Vancouver Coastal Health, and community organizations. The care model will encompass services provided by GPs, gynecologists, psychiatrists, endocrinologists, and plastic surgeons, with the goal of developing a a pathway template that can be spread to other communities in the province.
Nanaimo, South Island, and Shuswap North Okanagan divisions have partnered with local stakeholders to create youth clinics at local high schools that provide safe, accessible, inclusive health care to students, including those who identify as LGBTQ. These clinics enable students to access care in a convenient, confidential environment without worrying about organizing transportation or needing to miss school to attend an appointment.
At Nanaimo division's John Barsby and Nanaimo District Secondary School Wellness Centres, care is provided to LGBTQ+ students by a team of physicians, nurses, and counsellors, encompassing all aspects of physical and mental health. There is signage posted throughout the wellness centres and school buildings advertising the centres' services as confidential, non-judgmental, and welcoming to LGBTQ+ clients. Students can access education materials at any time, and wellness centre staff have received extra training in providing health care to LGBTQ+ youth.
In addition to its school clinics, the South Island division has also opened a youth clinic at Ocean Pier Medical Centre in Sidney, which has become a known safe space for LGBTQ youth due to its non-binary setting.
To learn more about these projects, visit the links below.
Dr Joy Russell, a member of the Vancouver Division of Family Practice, has been named Family Physician of the Year in BC by the College of Family Physicians of Canada. Dr Russell, who has been a physician in Vancouver for 33 years, is one of 10 family doctors across Canada being honoured with the Family Physician of the Year designation in 2017. The award recognizes family doctors across the country who provide exceptional care to their patients, contribute to the well-being of their communities, and demonstrate leadership in family medicine education and research. >
With the goal of better supporting improved access to care and quality of care for patients, the GPSC has introduced changes to some physician incentive fees. The changes were made in response to physician input and to support the goal of expanding and enhancing team-based care. >
A new wellness centre at the Sullivan Campus of Salmon Arm Secondary will provide health care services and mental health support to local students who may otherwise encounter barriers in accessing care. >
In 2016, three school-based clinics opened with help from the coordinating activities of the Sooke/ West Shore LAT on Vancouver Island, which brought multiple agencies and individuals to the table to hammer out agreements. >
Vulnerable populations in Abbotsford have better access to health care thanks to a collaborative effort between the Abbotsford Division, Fraser Health, the Salvation Army, and community partners including Medical Towers Pharmacy. >
Two upcoming operational changes by the GPSC will enhance their linkages with local and regional collaborative tables, while providing more flexibility to support turning provincial policy and strategy into action. >
The movement towards team-based care in BC is helping to ensure that doctors are better supported in providing comprehensive primary care to their patients. Two recent examples from the Abbotsford Division of Family Practice show the benefits that a team approach can have on a practice. >
The South Okanagan Similkameen Division of Family Practice, like many other divisions around the province, is creating grassroots, community-based solutions to address the provincial opioid crisis at the local level. The division is committed to stemming the tide of opioid overdoses in its communities through a series of strategies to support patients who have chronic pain and opioid addiction issues, and the physicians who care for them. >
As of October 1, 2017, doctors will have access to a new GPSC fee that supports team-based care. The GP-Patient Email/Text/Telephone Medical Advice Relay fee will enable doctors to communicate effectively with patients and to delegate communications to their MOAs and allied health professionals. This incentive will be applicable to all patients. The introduction of this new fee is in addition to the committee’s changes to some of its incentives that better support physicians in practice to improve access to care and services for their patients. >
As part of its commitment to patient education, the Burnaby Division of Family Practice has created a video miniseries entitled “Why Your Emotional Health Matters” that provides patients with guidance in taking care of their own emotional and mental health, and educates them on practical and simple steps they can take to increase their emotional health and wellbeing. This three-part video series is part of the extensive “Empowering Patients” resource collection that aims to help patients better understand how to optimize their health through their relationship with their doctor and in their daily lives. >
The recent wildfires in BC’s interior caused a state of emergency that resulted in the largest medical evacuation ever undertaken by Interior Health. More than 400 patients were moved from Interior Health facilities in 100 Mile House, Alexis Creek, Ashcroft, and Williams Lake, and 60 physicians were displaced from those communities and the surrounding areas. >
People in the Penticton area who have mental health or substance use challenges are getting their lives back on track thanks to a committed, caring team made up of doctors, mental health professionals, and a social worker at the Martin Street Outreach Clinic. >
The Salt Spring Island Child and Youth Mental Health Local Action Team has created a youth suicide intervention toolkit, providing information and support to children and youth in the community who are struggling with suicidal ideation. >
In October 2015, the Victoria Division of Family Practice launched a series of physician-run group medical visits aimed at teaching patients cognitive behavioural therapy (CBT) skills to self-manage their issues with anxiety and depression. As of spring 2017, more than 1700 patients have participated in the program, which offers 12 hours of psycho-education in the group setting (provided at the same cost to the system as four 20-minute counselling visits with their family doctor). >
Click here to read an article in the Terrace Standard about Dr Appleton and his award win.
Dr Cecilia Siegling, a member of the Prince George Division, has won the 2017 My Family Doctor Award from the BC College of Family Physicians. The award honours the relationship between a family doctor and their patient, giving patients an opportunity to nominate their family doctor for providing outstanding care. >
The North Peace Division of Family Practice and two rural physicians—Dr Leta Burechailo, member of the Powell River Division, and Dr Nicole Ebert, member of the Northern Interior Rural Division—have been honoured with BC Rural Health Awards, which recognize physicians and organizations for their contributions to rural medical practice. >
Dr Margaret Myslek, a family physician in Oliver, was finding it challenging to make time to visit patients at nursing homes. But that changed last year, when she adopted a new office practice, which put rapid access appointment blocks into her calendar 2 to 3 days per week. Patients with simple issues that can be solved in 5 minutes are now routinely booked into these spots. >
Five members of the Ridge Meadows Division of Family Practice have won the Doctors of BC Excellence in Health Promotion Award, presented annually to individuals and organizations undertaking health promotion activities that improve access to care for vulnerable populations, engage individuals in community events, and encourage children and youth to pursue active, healthy lifestyles. >
On June 5, 2017, BC physicians involved in opioid addiction treatment switch to a new guideline from the BC Centre on Substance Use (BCCSU). “A Guideline for the Clinical Management of Opioid Use Disorder” will replace the College of Physicians and Surgeons of BC's (CPSBC) “Methadone and Buprenorphine: Clinical Practice Guideline for Opioid Use Disorder.” Among the recommendations, the Guideline for the Clinical Management of Opioid Use Disorder strongly endorses the use of buprenorphine/naloxone as the preferred first-line treatment option for opioid use disorder, as well as sets out the risks and benefits of buprenorphine/naloxone relative to methadone. >
Education and awareness are a key component in enabling physicians to provide the best possible care to patients who have pain management and opioid addiction issues. Recognizing this need, many divisions have been organizing CME and information sessions to update members (and other health care professionals) on topics like pain management and addiction services available in their communities, patient self-management strategies, and current opioid prescribing guidelines. >
The Comox Valley division has partnered with community representatives and local RCMP to establish a standardized approach to safe opioid practices in the community. >
New provincial guidelines suggest that withdrawal management is most effective when it is part of a long-term wellness and recovery plan, through which individuals may be linked with ongoing support services that may include a combination of psychosocial treatment interventions, psychosocial supports, residential treatment, and pharmacotherapies. >
The Nanaimo Division of Family Practice has developed an innovative way to support local doctors in caring for patients with addiction issues. Recognizing the importance of providing doctors with opportunities to become educated in Opioid Substitution Therapy (OST), members of the division’s physician advisory team concluded that physicians also need proactive support in order to gain confidence in the process for prescribing Buprenorphine-Naloxone (Suboxone and its generics). The team speculated that this support could be provided remotely, on a case-by-case basis, by addiction specialists acting as physician e-mentors. >
response to the growing opioid crisis in the province, many divisions
of family practice are supporting doctors and patients in their
communities by creating resources on opioid prescribing and pain
Kootenay Boundary has created a wide range of tools and resources to assist physicians in helping their patients manage chronic pain. >
In response to physician input, the GPSC has introduced incentive fee changes to support the goal of expanding and enhancing team-based care. >
The GPSC made two operational changes to improve linkages with local and regional collaborative tables, and provide more flexibility to support turning provincial policy and strategy into action. >