‘Quarterbacks’ needed
Commenting on the findings, Harman Chaudhry, MD, MSc, an orthopedic surgeon at Sunnybrook Health Science Center, Toronto, said: “Their main message quantified what many of us in health care already sense is true: That patients do benefit when there’s somebody, specifically a primary care provider, to quarterback their health care, look over the entirety of their care, and really know the patient.
“These are elective procedures, and joint replacement is a very siloed and episodic instance of care where we, as surgeons in hospitals, think we can control a lot of the presurgical and postsurgical care and really optimize patients,” he added. “But it’s clear that despite that, patients are still benefiting from having somebody who has known them for a longer period of time.”
The longstanding shortage of family physicians in Canada has worsened, especially since the beginning of the pandemic. The shortage means that many people are denied access to a family doctor of their own, said Dr. Chaudhry, who was not involved in the research.
“In Canada, there’s a large chunk of the population that is having difficulty accessing a primary care physician, so those patients have created their own primary care experience, taking advantage of walk-in clinics, perhaps urgent care centers, EDs when they need emergency care, and locum [tenens] physicians that may come into the community once in a while. And so, they have created their own primary care experience, but there is not a single person or single medical home where they’ve been seen for a period of years,” he said.
“Many of the patients in this study who were in the ED had nobody that the surgeon could communicate with or send his notes to,” Dr. Chaudhry concluded.
No source of funding for this study was reported. Ms. Lethbridge and Dr. Chaudhry reported no relevant financial relationships. One coauthor received travel support from Stryker and DePuy Synthes, has stock or stock options in Stryker, and participated in a data safety monitoring board for Hip Innovation Technology.
A version of this article first appeared on Medscape.com.