For much of the last century, a family practice meant a physician, a receptionist and perhaps a nurse. That picture is changing. Provinces across Canada are funding interprofessional primary care teams, and Ontario's Family Health Teams have been part of that landscape for close to two decades. The idea is simple: patients get care from the professional best placed to provide it, and physicians spend more of their time on work only a physician can do.
What changes in the physician's day
In a well-run team, routine chronic disease follow-up, medication reviews, immunizations and many education visits move to nurses, nurse practitioners and pharmacists. Social workers and dietitians take on needs that rarely fit a 15-minute appointment. The physician's schedule shifts toward diagnostic uncertainty, complex patients and supervision.
That shift is not automatic. Physicians in team settings often describe a new kind of work: reviewing and co-signing, answering questions from colleagues, and attending team huddles. Teams that plan for this time protect it in the schedule. Teams that do not can end up adding to the physician's load instead of reducing it.
What makes a team work
- Clear roles. Each profession knows which visits and tasks it owns, documented in shared protocols or medical directives where required.
- A shared record. Everyone charts in the same EMR, with agreed conventions for tasks, messages and follow-up.
- Short, regular huddles. Ten minutes at the start of the day to flag complex patients and gaps in the schedule.
- Working to full scope. Pharmacists, nurses and nurse practitioners contribute most when they practise to the full scope their college allows.
Questions to ask before joining or forming a team
How is the team funded, and how stable is that funding? Who decides which patients are rostered? How is physician time for supervision and consultation recognized? What happens when a team member leaves? Clear answers to these questions are a good sign that a team is built to last.
Team-based care will not suit every practice or every physician. But for many, it offers a way to spend more of the day on the work that drew them to medicine in the first place.
Articles on medical.ca are written for health professionals. They are general information and do not replace your own clinical judgment, your regulatory college's guidance or advice from a lawyer or accountant.