Team care clinics may be better than stand-alone doctor offices for a healthier population

Terrence McDonald is one of the family physicians at Sunridge Family Medicine Te
Terrence McDonald is one of the family physicians at Sunridge Family Medicine Teaching Centre. Kelly Johnston, Cumming School of Medicine
UCalgary study finds people have fewer emergency department visits and hospitalizations when they are supported by a health-care team

For the past two years, Dr. Terrence McDonald, MD, and a team of researchers from the University of Calgary and the University of Alberta have been investigating how continuity of care provided by community family physicians in Alberta impacts patient health outcomes. McDonald and his team wanted to understand how someone’s health is affected when they see their own family physician versus another family physician in the same clinic (a concept called clinic continuity).

"Clinic continuity means a clinic where you have multiple family doctors in the same clinic, who can give ’buddy system care’ for each other’s patients. They might be part-time providers or split their time between community clinic and other primary care settings such as long-term care or urgent care centres," says McDonald, assistant professor at the Cumming School of Medicine and lead author.

The data showed that there were fewer hospitalizations and emergency department visits for people who were seen within the same clinic if they didn’t see their own doctor, rather than going elsewhere. This was especially true for people with complex medical needs.

The study, published in Annals of Family Medicine, analyzed linked health administrative data from Alberta from 2015 to 2018. Researchers examined the relationship between both physician and clinic continuity and the rates of emergency department visits and hospitalizations, considering various levels of patient complexity. In the study, 44 per cent of patients were male and 56 per cent female.

McDonald says the ongoing relationship between a patient and their family doctor has long been linked to better patient health, however, this study shows it is the continuity of care that is critical and that having doctors practice in teams might facilitate better care continuity. The number of Albertans searching for a family doctor continues to rise. The Primary Care Networks report a 29 per cent increase in visits to the Alberta Find a Doctor website.

"Our findings suggest one solution to the doctor shortage could be creating more team-based health clinics and moving away from solo practices," says McDonald.

McDonald says there has been a lot more attention on rural health care and expanding educational opportunities to train more family doctors. He says the findings could help policy makers and governments with health-care planning.

"We are in a primary care battle for our patients, in Alberta, and in many regions across Canada and throughout the world. To be able to provide patients with high-quality care we need ongoing investment in developing our primary care system that supports team-based care," says McDonald. "These results provide some reassurance for part-time and shared practices, and guidance for primary care workforce policymakers."