As a practising family physician who is somewhat “dispirited,” I thank you for the insightful editorial exposing the rather useless generality of Roy Romanow's recommendations for primary care reform.1 You hit the nail on the head by suggesting that more resources are required for administrative support. I now spend more time in the office than I did 10 years ago to take care of the same number of patients. I have excellent staff — both nursing and administrative — but I can only “download” so much to them.
It seems to me that there are 2 main areas where more time is required. The first is direct patient care — managing patients during the extended period while they wait for a specialist referral and following up patients seen in our overburdened emergency departments and specialists' offices; as the editorial says, “Follow up with your family doctor” is a common instruction to patients in these situations. The second is the mounting paper pile. We are the truant officers for the Workplace Safety and Insurance Board of Ontario, schools, government and industry, and some days it seems that everyone has a form to fill out.
Michael Pray Family Physician Hamilton, Ont.
Reference
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