Representative quotes
| Quote no. | Quote |
|---|---|
| 1 | [The availability of PC holders] has kind of taken a rather large load away. … I get them [PC holders] involved at some point, because … I know a fair amount about it [palliative care], but it rolls off of them much easier than for me. (Case 4, participant 4, generalist family physician) |
| 2 | If I see a patient that I think [needs surgery], I will fast-track them to [the orthopedic surgeon]. Meaning, it doesn’t take them 9 months to see him, it takes them maybe a month to see him, because I have seen them, I have triaged the patient, and now I know … it’s time for an assessment in surgery, so they get fast-tracked. (Case 4, participant 3, SEM) |
| 3 | [CACs] provide another layer of expertise [whereby] they [CAC holders] could handle something or diagnose something in that area of expertise, and then the patient doesn’t have to go to [the urban centre] or go to a specialist, so the care can happen quicker and within the same community. (Case 2, participant 9, generalist family physician) |
| 4 | I couldn’t do what I do fee-for-service. For one thing … geriatricians have actual billing codes for what we do, family practice does not have billing codes for what I do. … We do comprehensive geriatric assessments, they take an hour to an hour and a half. … So, you couldn’t possibly bill family practice codes and do geriatric care. (Case 3, participant 2, COE) |
| 5 | You cannot do shared care and have both doctors paid at the same time in the model that we’re in. … So, if a family doctor wants to do shared care, obviously they’re going to bill for it, that’s kind of the point and the incentive, so we kind of work for free in those cases. And, I do it, to build capacity, but I’m not getting remunerated for it. (Case 6, participant 2, PC) |
| 6 | I tried to start a primary care sports medicine clinic, based out of a physiotherapy clinic, last fall … because there has never been a sports doc here before, the community doesn’t have the culture of that, so what I ended up doing was a lot of doubling up on what the family docs were already doing or on what the [emergency department] was doing. (Case 4, participant 3, SEM) |
| 7 | I’ve been able to put “PC” behind my “CCFP,” that’s it, really. … There’s no change in … I don’t think any of my colleagues even really noticed for the longest time. But they know me by the fact that I have extra training and I’ve been able to help them out of difficult situations. That’s how you make the impact. (Case 2, participant 8, PC) |
| 8 | I enjoy doing the work that I do at the care home. I don’t know if I would need or, honestly, want the extra one [certification, because I think if I did [obtain] the Care of the Elderly [certification] … there would probably be a reasonable expectation that I was going to provide extra services to the region, and I don’t know if I have time in my practice or my life to do that. (Case 2, participant 4, generalist family physician) |
| 9 | It’s not to say that I wouldn’t value having more people in those [CAC] roles, because if that improved my access, I would use some of them more. But I trained through a time and worked in a time [in which] that accessibility wasn’t always there. And so, I’ve learned how to not need them until I really need them. (Case 3, participant 7, generalist family physician) |
Note: CAC = Certificate of Added Competence, COE = Care of the Elderly, PC = Palliative Care, SEM = Sports and Exercise Medicine.