Office Policies – Rideau Crossing FHC

Policy Title: Patients Requesting to Switch Family Physicians

Updated: July 20th, 2017

Policy

Rideau Crossing Family Health Centre (Rideau Crossing FHC) patients occasionally ask whether they are able to switch to a different physician, either after the initial intake/first visit appointment or after receiving care from their assigned family physician.

Rideau Crossing FHC does not allow patients to switch physicians for the following reasons to:

practice a team-based approach to care where all family physicians are fully qualified to provide primary care to women, men, expectant mothers, seniors, children and infants
maximize physician availability and minimize physicians’ administrative tasks
prevent screening of patients and maintain respect for patients and physicians by not discriminating or supporting discrimination. For example, patients are not assigned to physicians based on the patient’s age, gender, ethnicity or religion
optimize physicians’ responsibility for duty of care.

This policy:

promotes long-term patient-physician relationships
reduces the handover of high-risk patients
disallows requests based on the gender of the physician.

Policy Detail

Continuity of care between patient and primary care physician is important. Maintaining a long-term physician-patient relationship reduces the risks associated with patient hand-overs, an event which can be associated with a greater probability for loss of information or disruption to a plan of care. If a physician’s approach is not meeting their needs, patients are encouraged to schedule an appointment with their physician to discuss their concerns. Patients should request an extended appointment time for a more in-depth patient-physician conversation.

Rideau Crossing FHC promotes collaborative interdisciplinary care. Each physician is responsible for planning the care of patients registered to them, and share a common philosophy about patient care. However, the team shares a collective responsibility to ensure access to urgent appointments and coverage while another physician is on vacation or extended leave.

A challenge for physicians is the amount of administrative work involved. For every hour of seeing and providing care to patients directly, there may be another hour of paperwork and other administrative tasks required. With increasing legal and regulatory requirements, the proportion of administrative work required of physicians has been growing. One particularly time-consuming task for physicians is the work associated with taking over responsibility for the care of a patient. On average, every new patient involves several hours of work comprising an initial intake meeting, a detailed review of the old medical records, and developing an optimized patient medical record. This investment of time and resources is lost in the event of a switch, and the new physician needs to redo this entire process. Restricting patients switching physicians helps to maximize physician availability for face-to-face patient care.

As a professional, it is a physician’s duty to provide appropriate and quality medical care in the patient’s best interest. Fulfilling this duty means sometimes saying no to patient requests, for example should a patient request a prescription for a controlled medication such as a narcotic painkiller, and the physician’s professional assessment is that it is not safe nor appropriate. Further, a physician’s duty of care could mean recommending an unpopular or unwelcome treatment. In a collaborative team-based clinic, allowing patients to switch physicians undermines this duty of care and could lead to a situation whereby the new physician is put in a position of conflicting loyalty to his/her colleague versus his/her newly acquired patient, and possibly increases the risk of the new physician making a medical error.

Summary

For the reasons above, all Rideau Crossing FHC physicians and staff members support a policy that maximizes continuity of care and therefore restricts patients switching physicians.