Family physician leadership during the COVID-19 pandemic: roles, functions and key supports

Mathews, Maria; Ryan, Dana; Hedden, Lindsay; Lukewich, Julia; Marshall, Emily Gard; Brown, Judith Belle; Gill, Paul; McKay, Madeleine; Wong, Eric; Wetmore, Stephen J.; Buote, Richard; Meredith, Leslie; Moritz, Lauren; Spencer, Sarah; Alexiadis, Maria; Freeman, Thomas R.; Letto, Aimee; Ryan, Bridget; Sibbald, Shannon L.; Terry, Amanda

doi:10.1108/lhs-03-2022-0030

Cited by 18 publications

(20 citation statements)

References 15 publications

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“…The lack of priority placed on primary care in pandemic responses, including in the planning for PPE, has been reported in other highincome countries [38][39][40][41]. The limited representation of primary care leaders in pandemic response decisionmaking bodies [9,42] contributed to hospital-centric PPE plans, and under-appreciated both the potential risk of COVID-19 to primary care providers [43], as well as the contribution of primary care in alleviating demand for hospital-based services [16].…”

Section: Discussionmentioning

confidence: 99%

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

et al. 2023

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Background Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians’ (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning. Methods As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis approach was employed to identify recurring themes. For the current study, we examined themes related to PPE. Results A total of 68 FPs were interviewed across the four regions. Four overarching themes were identified: 1) factors associated with good PPE access, 2) managing PPE shortages, 3) impact of PPE shortages on practice and providers, and 4) symbolism of PPE in primary care. There was a wide discrepancy in access to PPE both within and across regions, and integration with hospital or regional health authorities often resulted in better access than community-based practices. When PPE was limited, FPs described rationing and reusing these resources in an effort to conserve, which often resulted in anxiety and personal safety concerns. Many FPs expressed that PPE shortages had come to symbolize neglect and a lack of concern for the primary care sector in the pandemic response. Conclusions During the COVID-19 pandemic response, hospital-centric plans and a lack of prioritization for primary care led to shortages of PPE for family physicians. This study highlights the need to consider primary care in PPE conservation and allocation strategies and to examine the influence of the underlying organization of primary care on PPE distribution during the pandemic.

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Section: Discussionmentioning

confidence: 99%

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

et al. 2023

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“…20 Study findings also highlight education and training needs for family physicians. For example, family physicians may need additional training (eg, courses and continuing professional development certifications) to ensure that they have the specific skills needed to provide pandemic leadership 21 or conduct virtual visits. 22…”

Section: Discussionmentioning

confidence: 99%

The roles of family physicians during a pandemic

Mathews

Meredith

Ryan

et al. 2022

Healthc Manage Forum

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Family physicians play important roles throughout all stages of a pandemic response; however, actionable descriptions outlining these roles are absent from current pandemic plans. Using a multiple case study design, we conducted a document analysis and interviewed 68 family physicians in four Canadian regions. We identified roles performed by family physicians in five distinct stages of pandemic response: pre-pandemic, phased closure and re-opening, acute care crisis, vaccination, and pandemic recovery. In addition to adopting public health guidance to ensure continued access to primary care services, family physicians were often expected to operationalize public health roles (eg, staffing assessment centres), modulate access to secondary/tertiary services, help provide surge capacity in acute care facilities, and enhance supports and outreach to vulnerable populations. Future pandemic plans should include family physicians in planning, explicitly incorporate family physician roles, and ensure needed resources are available to allow for an effective primary care response.

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“…Given the regional variation in local needs and the organization and delivery of care, family physicians need to be involved in leadership positions in pandemic planning and redeployment decisions. 26 Pandemic plans need to ensure that the infrastructure, resources, and training needed to carry out pandemic roles are available to family physicians. Most family practices in Canada operate as private businesses and therefore, communicating and coordinating with individual practices may be difficult, especially if family physicians do not have formal linkages with regional or institutional networks or have regional governance structures.…”

Section: Discussionmentioning

confidence: 99%

“…Primary care physicians in Europe (including the United Kingdom) and the United States reported a reduction in their ability to provide routine primary care, rapid adoption of virtual care, and limited anticipation of the need to sustain primary care for an extended period during the pandemic. 26,38,[40][41][42] Studies have also noted that the pandemic has highlighted the importance of primary care to patient health 14,36,37,43 and primary care physicians from the United States have similarly pointed to the need to leverage the unique patient-physician relationship in pandemic response. 43 Limitations Pandemic experiences and primary care systems in other regions may differ.…”

Section: Discussionmentioning

confidence: 99%

Strengthening the integration of primary care in pandemic response plans: a qualitative interview study of Canadian family physicians

Mathews¹,

Ryan²,

Lukewich³

et al. 2022

Br J Gen Pract

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Background: As the first point of contact in healthcare, primary care providers play an integral role in pandemic response. Despite this, primary care has been overlooked in previous pandemic plans, with a lack of emphasis on ways in which the unique characteristics of family practice could be leveraged to create a more effective response. Aim: To explore family physicians’ perceptions of the integration of primary care in the COVID19 pandemic response. Design and Setting: Descriptive qualitative approach examining family physician roles during the COVID19 pandemic across four regions in Canada. Method: We conducted semi-structured qualitative interviews with family physicians and asked about their roles during each pandemic stage, as well as facilitators and barriers they experienced in performing these roles. Interviews were transcribed and a thematic analysis approach was employed to develop a unified coding template across the four regions and identify recurring themes. Results: Sixty-eight family physicians completed interviews. Four priorities for integrating primary care in future pandemic planning were identified: 1) improve communication with family physicians, 2) prioritize community-based primary care, 3) leverage the longitudinal relationship between patients and family physicians, and 4) preserve primary care workforce capacity. Across all regions, family physicians felt that primary care was not well-incorporated into the COVID19 pandemic response. Conclusion: Future pandemic plans require greater integration of primary care to ensure the delivery of an effective and coordinated pandemic response. Strengthening pandemic preparedness requires a broader reconsideration and better understanding of the central role of primary care in health system functioning.

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Family physician leadership during the COVID-19 pandemic: roles, functions and key supports

Cited by 18 publications

References 15 publications

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

The roles of family physicians during a pandemic

Strengthening the integration of primary care in pandemic response plans: a qualitative interview study of Canadian family physicians

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