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Researcher Reveals New Model That Could Help Primary Care Crisis

Benefits of Ontario's Family Health Team approach reported in Annals of Family Medicine

A University of Missouri School of Medicine professor has examined a new approach to delivering primary care in an article published online today in the Annals of Family Medicine. The article, titled "Progress of Ontario's Family Health Team Model: A Patient Centered Medical Home," addresses how a Canadian province's experiences could provide useful lessons for the U.S in improving health care access and quality for patients.

Co-author Jack Colwill, MD, professor emeritus of family and community medicine at MU and Institute of Medicine member, believes some of the principles from Ontario's Family Health Team (FHT) model, which was implemented in 2005, could apply to U.S. health care reform.

"Ontario's program has seen higher satisfaction from patients and from the physicians who serve them. It's a valuable example for our country," Colwill said. "In the U.S., we continue to face a tremendous shortage in primary care which can only get worse as health reform is implemented. We need to consider a new approach such as this as one step to increase the number of primary care physicians."

Colwill served as a lead author in a 2008 Health Affairs study published by researchers from MU and the U.S. Department of Health and Human Services that predicted population growth and aging alone will increase family physicians and general internists' workloads by 29 percent between 2005 and 2025. The number of graduates in family medicine and general internal medicine actually declined 21 percent between 1998 and 2005.

Colwill learned about the new model of primary care in Ontario from the Annals of Family Medicine article's lead author, Walter Rosser, MD, professor emeritus in the Queens University Department of Family Medicine. Colwill approached Rosser in early 2009 to find out more about the model's effectiveness. Colwill and Rosser described the model in a publication they co-authored in the New England Journal of Medicine in 2010.

According to the Annals of Family Medicine article, the FHT model is designed to expand the capacity of primary care through the development of multidisciplinary teams that focus on providing a more comprehensive and coordinated 'basket' of services. The model also includes a reimbursement system that creates incentives for physicians and nurse practitioners to enhance preventive care and provide more proactive management for patients with chronic illnesses. Today, there are more than 170 FHT practices in Ontario with 1,500 physicians providing care for nearly 2 million Ontarians.

Colwill is a former chair of MU's family and community medicine department and has been a member of the Institute of Medicine of the National Academy of Sciences since 1989. MU's family and community medicine department has been ranked as one of the top 10 family medicine programs in the country for more than 15 years.

The AFM article is available online at:

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