Kiran Tara, Thelen Rachel, Szymanski Kirsten, Daneshvarfard Maryam, Rajendra Kanya L, Lim Jeanette, Garabet Mirna, Mayer Lucie, Black Steven, Waterbury Jordan D, Katz Alan, Condon Amanda, Lavergne M Ruth, Stringer Katherine, Breton Mylaine, Kovacina Neb, Buss Mandy, Kay Jasmin, MacLeod Peter, Mitra Goldis
Staff physician in the Department of Family and Community Medicine and Scientist in the MAP Centre for Urban Health Solutions at St Michael's Hospital, Unity Health Toronto in Ontario; is Fidani Chair of Improvement and Innovation at the University of Toronto; and is Associate Professor in the Temerty Faculty of Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto.
Research Coordinator in the MAP Centre for Urban Health Solutions.
Can Fam Physician. 2025 Jun;71(6):396-405. doi: 10.46747/cfp.7106396.
To present recommendations from 5 provincial reference panels conducted as part of the OurCare initiative, the largest-ever national effort to engage the public about the future of primary care in Canada.
Each provincial reference panel included 30 to 36 members of the public who were randomly selected to represent the demographic characteristics of that province. Panels were held in Nova Scotia, Quebec, Ontario, Manitoba, and British Columbia.
OurCare panelists spent up to 40 hours learning about primary care from experts in each province and deliberating to reach consensus on values, issues, and recommendations. Provincial advisory committees were composed of clinician leaders, policy-makers, and researchers. In each province, OurCare panelists collectively developed a report summarizing the results of their deliberations.
Panels in all 5 provinces identified 3 major challenges affecting primary care: a growing health workforce crisis, inequitable access to care, and fragmented services. Participants emphasized that everyone in Canada should have timely, equitable access to primary care, and called for a system that is prevention-focused, inclusive, patient-centred, and accountable. In all provinces, panelists recommended expanding team-based care, improving health professional retention and recruitment, ensuring patient access to health records, addressing the social determinants of health, and educating and empowering patients.
Results from the reference panels provide actionable direction for health system leaders, policy-makers, family physicians, and others engaged in health system improvement.
介绍作为“我们的关怀”倡议一部分开展的5个省级咨询小组的建议，这是加拿大有史以来最大规模的让公众参与讨论初级医疗未来的全国性活动。
每个省级咨询小组包括30至36名公众成员，他们是随机挑选出来以代表该省人口特征的。咨询小组会议分别在新斯科舍省、魁北克省、安大略省、曼尼托巴省和不列颠哥伦比亚省举行。
“我们的关怀”倡议的小组成员花费长达40个小时向各省专家学习初级医疗知识，并进行讨论以就价值观、问题和建议达成共识。省级咨询委员会由临床医生领袖、政策制定者和研究人员组成。在每个省份，“我们的关怀”倡议的小组成员共同撰写了一份报告，总结他们的讨论结果。
所有5个省份的咨询小组都确定了影响初级医疗的3个主要挑战：日益严重的医疗劳动力危机、医疗服务获取不平等以及服务分散。参与者强调，加拿大的每个人都应该能够及时、平等地获得初级医疗服务，并呼吁建立一个以预防为重点、包容、以患者为中心且负有责任的体系。在所有省份，小组成员都建议扩大团队式医疗服务、改善医疗专业人员的留用和招聘情况、确保患者能够获取健康记录、解决健康的社会决定因素问题，以及对患者进行教育并赋予其权力。
咨询小组的结果为卫生系统领导人、政策制定者、家庭医生以及其他致力于改善卫生系统的人员提供了可付诸行动的指导方向。
