Patients Switching Family Physicians

Policy Category: Human Resources Effective Date: January 2016
Policy Title: Patients Switching Family Physicians Review Date: January 2019
  Supersedes: none

Policy Title: Patients Switching Family Physicians

A question that occasionally arises at the Village Family Health Team is whether patients are able to switch among different physicians,

Village FHT does not support patients switching among family physicians because we:

  • practice a team-based approach to care;
  • work to maximize physician availability;
  • believe this policy supports sound decision making.

Continuity of care between patient and primary care physician is important. Maintaining a long term family physician/patient relationship reduces the risks associated with patient hand-overs, an event which can be associated with a greater probability for loss of information or disruption to a plan of care. If a physicians’ approach is not meeting their needs, patients are encouraged to schedule an appointment with their physician to discuss their concerns. Village FHT offers extended appointment times to enable a more in-depth patient-physician conversation. Just ask reception to schedule a longer appointment.

Village FHT is a collaborative interdisciplinary care team. Each physician is responsible for the care planning for patients registered to them. However the team shares a collective responsibility to ensure access to urgent appointments and coverage while another physician is on vacation. Village FHT also has a common philosophy towards patient care that is shared across the team.

One of the modern challenges for family physicians is the amount of administrative work involved. For every hour of seeing and providing care to patients directly, there may be up to another hour of paperwork and other administrative tasks required. Generally speaking, the proportion of administrative work required has been increasing, commensurate with ever increasing legal and regulatory requirements.

One particularly time-consuming task for physicians is the work associated with taking over responsibility for the care of a patient. On average, every new patient involves several hours of work comprising an initial half-hour meeting, a detailed review of the old medical records, and constructing and configuring an optimized patient medical record. This investment of time and resources is lost in the event of a switch as the new physician needs to redo this entire process. In the aggregate, restricting switches among physicians helps to maximize physician availability to provide face-to-face patient care.

As a professional, it is a physician’s duty to provide appropriate and quality medical care. Fulfilling this duty means sometimes saying no to patient requests or making an unpopular treatment recommendation. In a collaborative team-based clinic, allowing switches among physicians undermines this duty. Furthermore, it creates a sometimes uncomfortable situation whereby the new physician is put in a position of conflicting loyalty to his/her colleague versus his /her newly acquired patient.

For the reasons above, all physicians and allied team members of Village FHT advocate for a policy that supports continuity of care and ultimately restricts patients switching among physicians.