“Barking up the right tree”: challenges for health care reform

Abstract

Current approaches to health care reform are largely based on the metaphor of imminent flood waves threatening to inundate the health care system. This metaphor reflects the system's preoccupation with disease and disease management in a hospital‐centric environment. We suggest that the debate needs to be reframed around health, or more precisely the patient's health experience. Most patients are healthy most of the time, and even those with identifiable morbidities generally regard themselves as being in good health. The majority of people receive most of their care in the community from primary care professionals. An integrated, effective and efficient primary health care system supports continuity of care through a primary care provider and fosters clinical leadership that is supported by other primary health care professionals and medical specialists. Each primary care setting will have its own model that best provides flexible and responsive services to meet its patients’ needs and expectations.

Healthcare reform: implications for knowledge translation in primary care

“…First, it suggests that the translation of information on evidence-based sexual healthcare into patient care is possible during ‘the single biggest health reform in a quarter of a century’ [9], p. 2. Despite an uncertain climate [91,92], and the potential distraction from quality patient care [93,94], respondents reported a perceived change in their clinical capacities following the use of the resources.…”