Primary Care

is the Scientific Director of the Canadian Institutes of Health Research , and a Professor in the Departments of Medicine and  Epidemiology & Biostatistics in the Faculty of Medicine at McGill University, Canada

is a practicing physician and the Director of the – Policy Studies in Family Medicine & Primary Care -  in Washington, DC

 

, an American author and spiritual leader, was probably talking about individual level transformation when he said “We need to realize that our path to transformation is through our mistakes. We're meant to make mistakes, recognize them, and move on to become unlimited.” But the statement has a lot of validity even applied to system level transformation.

Canada and the United States share the dubious honor of ranking near the top of nations for total healthcare costs and near the bottom for health outcomes, whether measured in terms of individual health or health system performance. But it is through the recognition of these mistakes that both countries have embarked on a path toward transformation.

While differences between the two systems of health care delivery are frequently emphasized, we actually face some common challenges to primary care transformation ...continue reading

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

The concept of the “Salon” is based on the tradition of European intellectual gatherings that led to the great literary, artistic and political movements of our time. At a in Colorado Springs, gathered a group of colleagues in this way together to create discussion, debate and perhaps generate ideas. Such gatherings might take place with any group and in any context - in a department, region or nationally. On this occasion, Frank attracted a group of about twenty delegates of the NAPCRG meeting from various international and professional backgrounds and I was fortunate enough to be included. ...continue reading

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is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

How do you create a successful school of primary care research?  Measuring outputs through academic papers, presentations at international meetings, and the general impact of research, the UK primary care community has had remarkable success. The of the School of Primary Care Research () in England was an opportunity to reflect on their achievements and try to pick out the key factors in that success.

It wasn’t always this way. As an academic and an editor I know the struggle that researchers had in the early days. There were few grants, ...continue reading

jack_westfall is a Professor of Family Medicine and Director of the . Dr Westfall will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) .

 

The High Plains of eastern Colorado have been referred to as a dwindling remnant of the “”, reminding us of a not too distant past that included the dust bowl and westward out-migration to the West Coast. Rural Colorado has become mostly a crop-circle curiosity or a time to “put your seat into the upright and locked position” for the thousands of travelers that fly over at 30,000 feet. The small town of Last Chance, Colorado sits at the junction of 2 . It is home to just 22 residents.

Last Chance once had a Dairy King and 2 gas stations, and was for many, the last chance for food and fuel before heading east into the vast open plains of eastern Colorado. ...continue reading

is Deputy Editor at CMAJ. She is currently attending the North American Primary Care Research Group (NAPCRG) in Colorado Springs, CO.

 

In the plenary session on providing primary care for refugees, one of the speakers, Kim Griswold, shared an image, now familiar to many, that is designed to help people to understand the difference between equality and equity. It demonstrates how some people start off at a relative disadvantage and need extra help to be able to achieve or access things that more advantaged people are able to experience equityeasily. This image, and similar ones, have been criticized by some social justice thinkers who point out that ...continue reading

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He is currently attending the North American Primary Care Research Group (NAPCRG) in Colorado Springs, CO.

 

Not many primary care doctors have an 8 billion dollar budget. Mitch Katz, who gave the opening keynote address at NAPCRG 2016, is director of the which combines the Departments of Health Service, Public Health and Mental Health into one service. He continues to see patients and described how he had become so specialised in his career in a primary care AIDs clinic in San Francisco, that he found returning to generalist practice extremely difficult. When he focused on AIDS he was on top of his topic like any specialist, but, as a generalist, he had to cope with anything from a heart attack to broken heart.

Los Angeles, until recently, had no ambulatory care ...continue reading

griswold is Associate Professor of Family Medicine, Psychiatry, and Public Health and Health Professions at Jacobs School of Medicine and Biomedical Sciences in Buffalo, New York. Dr Griswold will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) .

 

Communities in every nation are faced with providing competent, equitable and culturally appropriate services for resettling refugees. Health centric disciplines are not enough to meet the challenges presented by these newly arriving populations, nor to alleviate the disparities they face – such as isolation, limited English proficiency, differences in patients’ attitudes and health literacy levels, and a lack of cultural awareness on the part of providers.

Health inequity can be defined as: “unjust differences in health between persons of different social groups.” ...continue reading

spottie is Associate Professor of Family Medicine and Epi & Community Medicine at the University of Ottawa, as well as co-Chair of the Canadian Collaboration for Immigrant and Refugee Health, and a family physician at the Immigrant Health Clinic of Ottawa, which he helped to found. Dr Pottie will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) .

 

My residency training in Ottawa began with a wave of refugees from El Salvador and Guatemala.  Most conflict-affected refugees - Somali, Sudanese, Congolese, Karen, Bhutanese, Colombian - come quietly and settle rapidly in our communities.  And, even in instances when the media cover the arrival of large waves of refugees, such as the Vietnamese boat people or the recent Syrian war victims, the refugees themselves settle quietly in our communities.

In the early 1990s, it felt almost revolutionary to care for refugees. There were few primary care practitioners trained and ready to lead ...continue reading

harris is Foundation Professor of General Practice and Executive Director of the Centre for Primary Health Care and Equity at the University of New South Wales in Australia. Dr Harris will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) .

 

After working with refugee populations resettled in the urban fringe of Sydney in the 1990s, I began volunteer clinical work in 2000 with an NGO working with asylum seekers.  Asylum seekers do not have access to the national health insurance system that funds primary care for all Australians and subsidizes medications.  Despite having greater health needs due a variety of acute and chronic physical and mental health problems, refugees often suffer worse access to health care in resettlement countries like Australia. ...continue reading

hauckf is Professor of Family Medicine and Public Health Sciences at the University of Virginia. Dr Hauck will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) .

 

The scope of the crisis is staggering!  The number of people displaced by war, conflict or persecution has hit a record high—over 65 million with 21 million of these being refugees. Most face an uncertain future. Those who are resettled to a developed country are among the lucky ones. Nonetheless, they face many challenges in their new home, including accessing culturally sensitive health care.

My involvement with refugees began on the Thai-Cambodian border, where I spent a year providing primary health care to Cambodian refugees who were living in the largest border camp, having fled there after the Khmer Rouge were ousted after years of genocide. Moving to Charlottesville, Virginia, in 2000, I never expected to find that refugees were being resettled in this small city. ...continue reading