The Hamilton Spectator published an article on December 23, 2023
By Joanna Frketich
Over 300,000 Hamiltonians now have somewhere to turn for help after Ontario’s largest family health team added a patient relations program to fill a key gap in primary care.
While hospitals, long-term care homes and home care are mandated by law to have a patient relations role to handle complaints, there is no equivalent requirement in family medicine.
As a result, Ontario’s patient ombudsman highlighted a “notable and troubling” increase in complaints related to primary care in his annual report for 2022/2023 released Nov. 15. The report flagged that these complaints are outside of the jurisdiction of the ombudsman and show patients have trouble accessing family doctors, have limited options for care and “often have nowhere to turn.”
“What it said to us was people who had issues with their care were having challenges getting some resolution to those complaints,” patient ombudsman Craig Thompson told the Spectator. “That speaks to a lack of formal complaints processes.”
The Hamilton Family Team is trying to bridge that divide by creating a patient relations program that would cover the 166 family doctors and over 250 other health care workers in 91 locations that are part of the group-based practice.
“I think it's one of the first of its kind,” said Claudette Moulton, who is leading the program. “This position has been around for a long time in hospitals, long term care and home and community care … and it has worked really well in those other settings … to elevate the patient's voice so that the patients have a way to share their feedback, their concerns and their compliments.”
Moulton has been using her 20 years of experience in patient relations at Ontario hospitals as a foundation while building the primary care program since June.
“Patient relations really is to help individuals navigate the health care system,” said Moulton. “If you have a question, concern or a complaint that you need a neutral person to help you navigate or to help be your voice to make sure that your concerns are heard and to follow through, I'm here as the go between.”
While Moulton encourages patients to speak directly to their health care providers, that isn’t always enough to resolve outstanding issues.
“Sometimes people don't feel comfortable doing that for whatever reason and they want a neutral person … to help facilitate that conversation with their care providers and that's why I'm here,” she said. “There are so many things that can happen when two parties aren't communicating very well. Having a mechanism to just sit down and talk about what went wrong and how we can change it really helps to improve the system for everyone.”
Patient relations goes well beyond resolving individual issues to identifying wide-reaching problems that need to be fixed, she said.
“Sometimes there's gaps in the system that we're not aware of,” said Moulton. “When patients bring that to our attention, we're able to look at that, flesh it out, and make changes.”
Moulton has already had 90 people reach out, although the majority are Hamiltonians desperately seeking a family doctor.
“The biggest theme that I'm getting so far is access,” said Moulton. “There are so many patients who do not have a primary care doctor so helping people navigate that and helping them find their way in terms of who is accepting new patients, I think is quite a benefit.”
The patient ombudsman also found accessing providers and navigating the health care system to be the driving issues behind the 4,300 complaints outside of his jurisdiction – 75 per cent of those came from primary care. It was an increase of 33 per cent compared to the year before.
“Primarily the complaints coming from primary care were about delays in care and communications and it speaks to, in our opinion, the challenges that those sectors are going through when it comes to staffing and the demands that have been put on health care providers,” said Thompson.
Examples of complaints included difficulty getting through to the doctor’s office, delays in getting appointments, test results not being provided in a timely way and other delayed care.
“When you have a system that is under stress, you're going to get these kinds of complaints,” said Thompson. “It all speaks to the pressures that sector is experiencing.”
The annual report said its resolution specialists had to connect patients to regulatory colleges, hospital patient relations or other organizations because primary care generally doesn’t have a dedicated role to resolve these issues.
“I think it's a wonderful idea to do it in that more formal way of actually creating a dedicated resource to patient relations,” said Thompson. “A lot of family health teams have complaints processes in place, but it's typically the executive director or the CEO. They're sort of managing that on the side of their desk because they've got a lot of other responsibilities. But when you actually put a patient relations person in place, that's their focus.”
Thompson said it also ultimately leads to better care.
“A fundamental purpose of being able to take complaints is so you can get to some resolutions,” he said. “That just shows a commitment to doing better and improving quality.”