Categories > President’s Messages

Patient’s Medical Home and Future Practice in Canada

The Patient’s Medical Home is the future of family practice in Canada. In this vision, every family practice across Canada offers the medical care that Canadians want: Seamless care that is centred on individual patients’ needs within their community, throughout every stage of life, and integrated with other health services.

Having this clear, compelling vision for the future of family practice is the first step in making it happen. Can you see this for your practice? Does it exist for your patients? Are you leading your practice and peers to make it a reality? The implementation of the Patient’s Medical Home in Alberta is well on its way. We are doing a lot of things right, but we need to continue on this trajectory to ensure the continued provision of quality care. Since I like to keep things simple, I suggest two key areas that I think we as family physicians need to focus on in Alberta right now:

Focus on Your Contribution to Seamless Care
In our practices, family physicians and their teams are working together to provide a system of front-line health care that is accessible, high-quality, comprehensive, and continuous. We take responsibility for the overarching and proactive medical care of patients, ensuring follow-up and facilitating transitions of care and/or referrals when required. The newly developed Family Medicine Professional Profile describes comprehensive medical care for all people, ages, life stages, and presentations. This care includes all clinical domains, both acute and chronic, and all stages, from preventive to palliative care. Family physicians work across care settings and regulatory environments. Take stock of how you are providing and supporting seamless care for your patients and know that no one else in the health care system can do what you do!

Focus on Your Engagement in Leadership
Are you a leader in your practice? Do others look to you for direction and advice? As family physicians, you are given an amazing opportunity to drive the evolution of your practice. From the most minute things like a coaching conversation with a peer, new team member, or learner, to a meeting to consider investments in new infrastructure or a piece of equipment for your practice, you are stepping up daily to the leadership challenge. There are so many physician leadership development opportunities and a growing community of leaders supporting each other in Alberta. Take a look and take part!

Keep it simple and find focus. What can you do today to advance your practice and more provide moreseamless care for your patients? What can we at the Alberta College of Family Physicians (ACFP) do to help? Keep in touch and let me know if there is anything you need to advance excellence in your practice.

Sincerely,
Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca

Leadership Is About the “Little Things”

Read the full March eNews and President’s Message.

“It takes team, grit, determination, and perseverance. If you trust in your people, and equally importantly, they trust you, amazing things can happen.” Darby Allen, Former Fire Chief, Fort McMurray, Alberta (Keynote, 63rd Annual Scientific Assembly)

As in emergency response, leadership in family medicine is not for the faint of heart. Primary care is being asked to lead and contribute through changing clinical delivery and practice, taking on more coordination and collaboration roles, reaching out to problem solve, and seek resources to achieve better results.

If you want to gain skills as a leader for your practice, your Primary Care Network, your Zone, or for the province, you will have to seek them out. You will find a great line up of speakers and leaders at ACFP’s second annual LeadFM Conference in Calgary on April 20 and 21, 2018. We hope that you can join us to start your leadership journey or to continue to network and collect leadership tools and resources that will support you and your team in your day to day delivery of family medicine.

But let us not forget, “it is about the little things.” I think what Darby Allen said about leadership also holds true for me. When working with my teams at the University of Alberta, Sylvan Family Health Centre, or the ACFP, I have to be purposeful about my actions to show appreciation for all of the work that everyone does that contributes to the delivery of medical student and resident education, patient care or good governance. I trust my team members to play their role to the best of their abilities and to do what they were trained for.

This year’s 63rd Annual Scientific Assembly was a true success and example of what can be achieved when you have an engaged team of physician leaders. Featuring inspiring and thought-provoking keynotes, like the one delivered by Darby Allen, to workshops focused on using integration and continuity to lead system transformation, our team of committee members and staff came together with grit and determination to deliver what one delegate said was “The best ASA I have ever attended!”

In this way we are all successful and “amazing things can happen.” We all can do our part to show leadership through appreciation. And in building strong leaders and strong teams, we can continue to produce exemplary events—our Annual Scientific Assembly being no exception.

Sincerely and in appreciation for all you do in your practices around Alberta,
Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca

Educating the Heart and Mind

Read the full February eNews and President’s Message.

“Educating the mind without educating the heart is no education at all.” Aristotle

Though medicine is based on facts and evidence, family medicine is all that and it draws on the heart, emotions, and social constructs of community, team, and family. We learn the technical aspects of medicine from reading, being tested, and attending lectures in medical school. Nonetheless, we really start to solidify what we are taught in medical school when we are given the opportunity to practice what we have learned with our teams, with our patients and their family members in practice.

Residencies, preceptorships, and mentorships throughout our professional careers are so critical. Practising alongside our teachers while we interact with and support patients helps us to develop competency and confidence because that is when the heart becomes engaged! The heart comes to be educated when emotion, caring, compassion and, sometimes, even frustration are present. That is when the learning moves from the mind to the heart.

Think about when you have learned something that changed your heart. Was it something you read, something you learned through trial and error, or something that you worked on together with a mentor or preceptor? Perhaps you heard a clinical story that captured your heart and has resonated throughout many years of practice.

We have access to so many opportunities to learn and engage in continuing professional development and through more formats and environments than ever before. Our goal at the ACFP is to connect different members—with different learning styles—to education that speaks most to them. It is not enough to learn from a book or a classroom setting, we must bring new ideas to life and apply them practically to the work you do, day to day. The designers of your continuing medical education and professional development must facilitate the journey from the mind to the heart.

As we are on the eve of the ACFP’s flagship conference, the Annual Scientific Assembly (ASA), we hope that what you experience there will move your mind and your heart. Let it be a place to meet and connect with old friends and new, to network and learn from people in your field of interest, to get updated on the newest clinical practices and to remember what brought you into family medicine.

Think about what “educating your heart” means to you and those you serve.

In your service,
Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca

Principle Based Leadership

Read the full January eNews and President’s Message.

Machiavelli said “Never waste the opportunity offered by a crisis” … but we ought to ensure we are consistent and fully in-line with our organizational principles!

A crisis shakes us out of complacency and forces us to challenge conventional wisdom so that we can create transformative change. When things get tough and decisions need to be made quickly, having a set of principles to guide you can allow freedom to create solutions and the structure to hold true to what the membership believes.

The Alberta College of Family Physicians is a principle based organization that prides itself in its role to strive for constant improvement and excellence. In the past several years, we have, collectively as family physicians, been challenged to provide leadership for change. As defined in our Strategic Framework 2017-2019, the principles that the ACFP has held up to guide us are:

  1. Professionalism: The ACFP acts with integrity, respect, and inclusiveness, upholding the social responsibility of family medicine.
  2. Continuous Learning and Professional Development: The ACFP supports and inspires self-directed and lifelong learning, quality improvement, research, and continuing professional development for family physicians so that they may adapt to changes in medical evidence, patient, and community needs.
  3. Patient Centred and Integrated Care: The ACFP is comprised of caring family physician leaders, who ensure comprehensive and integrated care and value excellence in health care inspired by personal interactions and trusting relationships in the communities they serve.
  4. Applied Leadership: The ACFP leads and participates in collaborative, practical, evidence-based initiatives with stakeholders to advance excellence in family medicine and the health care system.
  5. The Views and Needs of Our Membership: The ACFP is inclusive and reflective of its members’ views and needs, building awareness of the value of family medicine through responsive and adaptive communication, advocacy, research, engagement, and education.

It may appear mundane and oversimplified but this set of foundational principles has carried us through some difficult times. It is the leadership and Board of Directors of the ACFP who reflect and strive to live these principles whenever they work together on your behalf.

Let us know what you think.

Are we on the right track? I am always happy to hear from you about where you struggle and where you are succeeding in your practice so that we can continue to support and advocate for what you need to serve your patients well.

In your service,
Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca

ACFP’s Top Ten for 2017


Read the full December eNews & President’s Message.

Looking back on 2017,  we invested in advocacy, leadership, and education while supporting you and your teams in the delivery of care for your patients. Here are my thoughts on the ACFP’s Top 10 over the past year:

  1. We established a task force of 12 family physician members that informed the ACFP Opioid Crisis Response and put forward a set of recommendations that was sent to all stakeholders in primary care delivery,
  2. We continue to build on and expand our Family Medicine Leadership Program aimed at providing “Leadership Development for Where You Are,”
  3. Together with the AHS and AMA, we developed a portal to Engage Primary Care physicians in clinical and system level projects. To date, we’ve successfully linked more than 50 family physicians to active projects,
  4. We successfully orchestrated our 62nd Annual Scientific Assembly (ASA) for nearly 400 delegates, highlighting relevant CPD topics, family medicine research, and recognition of excellence, while serving as a gathering of friends and colleagues in a pristine location in the Canadian Rockies,
  5. Our Practical Evidence for Informed Practice (PEIP) Conference hosted over 400 delegates on site, with another 225 joining by webcast, to learn about the best evidence and practice recommendations in over 19 clinical areas,
  6. This December, we published our 200th Tools for Practice article since the inception of our 2009 collaboration with the University of Alberta’s evidence based medicine team—PEER (Patients Experience Evidence Research)—led by Drs. Mike Allan, Mike Kolber, and Tina Korownyk. The ACFP’s Tools for Practice articles are sent to more than 32,000 family physicians and primary care providers in Canada and across the globe,
  7. The ACFP Awards and Recognition program recognized Dr. Donald Chan of Edmonton as the Family Physician of the Year and added a new award category to recognize Outstanding Family Practice Teams that deliver on the principles of the Patient’s Medical Home. Be sure to check out all of our 2017 award recipients,
  8. We worked hard to revitalize and recruit to our governance and operational committees which advise on and support the work of the ACFP. Sincere thanks to our many volunteers for their commitment to the profession—we couldn’t do it without you,
  9. Our Board of Directors has been focused on setting the strategic direction of the ACFP through ongoing deliberations and in-depth discussions, as well as providing oversight and support to the management and staff at the office. Our Board is both vital and well connected to the membership, building relationships at events and using those opportunities to find out what we can do to support you in your practices,
  10. We continue to collaborate with a variety of partners in the delivery and design of the health care system and continue to be known for our high road approach. Learn more about how we work with the other organizations in Alberta by checking out our “Understanding Who’s Who in Alberta’s Health Care” document.

I look forward to another momentous year of progress and potential! Contact me anytime if you have questions, input, or feedback.

In your service,
Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca

 

October – Message From the President

Read the full October eNews & President’s Message.

Many of us have had our own brushes with the health care system, be it our own illness or through a family member. I have ​lived through such an experience recently through my father’s serious and very lengthy illness and hospital stay. Throughout his entire stay, the staff caring for my father have been phenomenal.

I, as the family member, have enjoyed a great deal of respect and engagement. So, it was with considerable surprise that I found all of it tarred with the experience of my father’s last day in hospital; the plan was for him to go to transition care. I called one morning, as I often did, to check on my father to see how he was doing. I was completely gobsmacked when I was told he had been discharged the day before to a completely different facility. Discharged without letting the family know? Further inquiries about this led to the reason being that “it was a chaotic day.”

On reflection, I realize that I am not alone in such an experience. Our health care system is broken. Many people (ourselves and patients) can attest to similar heart wrenching experiences. It is difficult to ​not to​ get angry when hearing about these stories. I was angry ​ initially​ but ​am ​more ​deeply ​troubled about how our system continue​s​ to function with such gaps.

What can we do as family physicians to prevent such lapses in communication?

Do our own clinic systems and processes lead to failures of important communications with our own patients?​ If so, do we have ways of recognizing these lapses and resolving them? The doctor patient relationship is so central to family medicine and what it means to be a family physician. And in turn, central to this relationship is trust.

Our patients trust us to communicate openly and transparently with them, even if the news is bad or something they would really rather not hear. Our patients also trust us to involve family, at their wish and expressed consent, family who need to understand what is going on and need to be involved in plans of management.

I trust you​, as family physicians,​ are doing what you can to be strong advocates for your patients. Advocacy is one of the CanMeds roles and we need to role model this and teach it to our learners. You are there for ​your ​patients to inform ​ and educate​, ​to help navigate a very complex health care system, ​to be leaned on, to offer guidance, or to just listen. But we cannot do it alone. It is a team effort to ensure continuity. We must have proper access to records and information on our patients. These principles of the Patient’s Medical Home need to continue to be the focus of our policy makers. And the ACFP will continue to advocate for this.

There will always be “chaotic days” to contend with. We must stay focused and ensure ​that our ​patients and their families are central to all actions and decisions​ within the system​.

Sincerely,
Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca

August – Message From the President

Read the full August eNews & President’s Message.

Advanced Care Planning – A Personal Perspective

Having an advanced care plan easily available to any health care professional—be it home care nurses, paramedics with EMS or nurses on an active care unit in hospital—is very useful. In our own clinic, we discuss a personal directive with every patient who has a review of their complex care plan. It would be good to include follow-up and incorporate a Green Sleeve to ensure completion of a personal directive. On reflection, why only during review of a complex care plan; why not incorporate this into an annual review with any patient?

I’ve recently had a very personal brush with legal documents such as Power of Attorney and Personal Directive. I was recognizing signs of illness in my own father and had embarked on obtaining these documents in a proactive manner. However, it may not have been truly proactive when one sees a family member deteriorating as proactive means doing this before something happens. My father then became seriously ill and was hospitalized quite suddenly before I had these documents ready. In the weeks following, I had to have documents transferred from my lawyer in Red Deer to a lawyer in Calgary, then have that lawyer meet with my father in hospital to get a Power of Attorney and Personal Directive in place. My father had the capacity to remain his own agent while this was being pursued, however, it could just as easily not have been the case. And, in all honesty, it was truly the Power of Attorney that was most important to my father. He was bedridden in hospital and could not look after his affairs (even though he knows the value of his bank accounts better than I know mine). Since having the Power of Attorney, I have looked after a tax installment, insurance payments and other bills, and my father is very relieved.

Is having the Green Sleeve on the refrigerator door the best place? I’m not sure. It needs be with the patient in question. I know of one case in which the family had done all the right things for a member of the family receiving palliative care. The Green Sleeve was on the door of the fridge, but this patient rapidly deteriorated, paramedics were called, but the Green Sleeve had disappeared (no one knows to where) and, as a result, there was no personal directive. A husband had to watch his terminally ill wife receive CPR when this was explicitly not her wish, yet there was nothing he could do.

The bottom line is to advocate with your patients to be proactive and explicit about advanced care planning and to have those plans readily available for when and where they are needed. It truly does provide a much higher quality of care for your patient.

Sincerely,
Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca

June – Message From the President

Read Full June Newsletter Here.

How the latest Auditor General’s report affects you as a Family Physician?

In the most recent report from the Office of the Auditor in AlbertaBetter Healthcare for Albertans May 2017, it is noted that many recommendations have been made over the last 25 plus years that have never been implemented because there are root causes that have never been resolved. The root causes this report identifies are:

  1. Fragmented structure of the health system
  2. Lack of integration of physician services and the services of other care providers
  3. Lack of sharing and use of clinical information

Integrated care is identified as the framework that is evident in the highest performing health systems in the world. We need a health system in Alberta where all parts work together to produce the highest quality of care for each patient. The Office of the Auditor General insists that “Significantly better health care is within reach” in Alberta if we overcome the challenges that have stood in our way.

In reviewing the report, here is what I see as the recommendations that matter to us as family physicians:

  • Building a system centered on patients with a single care plan based on the patients goals and teams to support that plan
    How do you contribute to care planning in your practice?

  • Integration of family physicians with the rest of the health care system
    How can you connect personally with other parts of the health care system in your daily practice?

  • Patients receive care in the most appropriate location which, most often, should be in a community setting rather than a hospital
    How can you expand your scope of practice to keep patients in your care rather than referring them to another part of the system?

  • Evidence based tools are available for decision making and care planning
    What are the ways you can ensure you have the most relevant and timely recommendations and guidelines for the care of your patients?

  • Linking funding and physician compensation to results
    Have you considered the impacts of a blended capitation model or other payment model for your practice? If so, what do you need to put in place to make a transition to new payment models?

  • Patients are engaged in their own care
    How do you involve your patients in their care planning? How do you maintain that engagement between visits?

  • Measurement and benchmarking of care quality and patient outcomes by everyone
    Are you looking at your own data regularly to see where improvements could be made?

We need to continue to take a leadership role in the stewardship of the health system through daily actions. I truly believe that we can improve how our health care system performs if we are diligent and take responsibility for our own contributions. Our patients will appreciate it.

Sincerely,
Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca

May – Message From the President

“Where are we headed?” and “Who is leading the way?” We have a collaborative government right now that values primary care and community. We are positioned in a time where resources are limited and the reality that we need to do things differently in order to provide the excellent results that health care spending should deliver on. Primary Care, with the concrete leadership of family physicians, is being asked to contribute and help to design systems that work.

At ACFP, we will do our part through supporting family physicians in Alberta through continuing professional development, advocacy, leadership and research that enables them to provide high quality health care for their patients and their communities. It is our vision as a Board of Directors for the ACFP is to advance health for patients, families and communities where every Albertan has a Patient’s Medical Home.

The goal is for every family practice in every community in Alberta to be able to offer comprehensive, coordinated, and continuing care to their populations through a family physician working with health care teams. This vision puts the needs of patients and their communities at the centre of care. The PMH vision also reinforces the physician-patient relationship and the importance of the Four Principles of Family Medicine. The PMH Vision is not going to happen without commitment to implementation from all of the leading organizations in Alberta.
We have strong working relationships with several other organizations in Alberta and Canada all banding together to create the conditions for better systems and supports to make the PMH Vision a reality. Check out our ACFP Who’s Who in Alberta Health Care document to see how we all work together.

If you have any questions about the ACFP, our role in the system and how we connect to our partners and leadership, please contact me at acfppres@acfp.ca.

Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca
Read Full May Newsletter Here.

March – Message From the President

On March 4, 2017 at the Annual Meeting of Members, the ACFP presented the President Installation of Dr. Fred Janke. Below is a transcript of his acceptance speech.

 

Dear Members,

I would like to thank outgoing president, Dr. Chmelicek for, his leadership over the last two years and the dedication and passion he has brought with his leadership. I have been with the Board for a number of years now and have been a part of the governance change we implemented in the last year to decrease the Board size and bring it from a representative Board to a smaller skills based Board. I provide corporate history and continuity through this change. I thank the dedication and hard work of Terri Potter, the executive director and all of the staff at ACFP. All have worked hard to build the representative voice of family physicians we provide to become an organization that we can all be proud of. In my other life I wear many hats: I am a family doc like all of you and work in the trenches in patient care; I’m part of a progressive patient’s medical home in which we work as a team; I have been an academic physician for fifteen plus years; I have advocated on behalf of rural generalism for just as long. This allows me to bring a very broad perspective to this position.

As we move forward, I would like to highlight the four pillars of the ACFP’s strategic framework and would like to propose that these be the four areas I devote my time and energy toward on behalf of the organization and all of you:

  1. Ensure that as family physicians, we continue to have access to high quality continuing professional development and best practice resources.
  2. That we continue to advocate on behalf of family physicians to influence public and health policy that supports excellence in patient care.
  3. That we as a Board and organization stay connected with you, our membership, and to build on the engagement of Alberta’s family physicians.
  4. That both public and government grow in the awareness of the value of family physicians, our vision and the concrete leadership we can provide to implement positive change.

My pledge is to work hard to ensure that the ACFP continues to be sought for guiding wisdom and continues to be a voice for family physicians in Alberta.

I cannot do this without you in turn supporting our organization and supplying voice, leadership, and wisdom where and when we need. I cannot do this without the support of our very capable Board and I cannot do this without the tireless efforts of the ACFP staff.

Thank you for honouring me with this position, the Presidency of the ACFP.

Dr. Fred Janke, BSc, MSc, MD, FCFP, FRRMS
President, Alberta College of Family Physicians
acfppres@acfp.ca
Read Full March Newsletter Here.

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