Grant: Doctoral Research Award - Primary Care

Primary health care (PHC) is the foundation of Canada's health care system. It is the provision of essential health care services for individuals and families in the community by a family physician who acts as a first point of consultation with the health care system and a coordinator of secondary care services. Canada lags well behind most industrialized nations in terms of quality of, and access to, PHC and myriad experts as well as the public, have advocated for fundamental change to the system. Although significant innovation has occurred on a very small scale, system-level reform remains elusive. This project attempts to take the first steps necessary to address why we seem unable to make sweeping change to PHC by examining constitutional, legislative, and historical structures that may be acting as barriers to change. This study will also examine one or more international examples of successful system-level reform with the goal of understanding the factors that facilitated the change process. In the final phase of the study, options for reform will be presented to individuals who are responsible for making management and/or policy decisions in Canadian health care. Options will fit within Canada's existing constitutional frameworks, but may involve changes at the legislative, policy, and/or delivery levels, informed by the results of the international studies. A focus of these interviews will be strategies for successful integration of any of the options for change, and the likelihood of success. An in-depth study of the barriers to and facilitators of system-level change will be instrumental for moving beyond the small-scale, towards systems-level innovation. This work will be the first set of projects in an interdisciplinary research portfolio, the goal of which is to elevate Canada's profile as a world leader in the provision of outstanding primary health care.