Hospital News 2025: Primary Care that is Essentially Unique
By: Jamison Falk
Originally seen in Hospital News
I’ll be the first to admit that I’ve always been fascinated with interesting styles, different design features, and aesthetically novel ways of doing things. We often refer to these things as unique. At the same time, the practical side of me asks, “are these things really necessary?”
In an environment of stretched health care resources and a primary care crisis, there’s little room for unique if it’s not essential. In 2022, an article published in the Journal of General Internal Medicine quantified what has been perceived to be true about the value of team-based primary care. Simulating the provision of full preventative, chronic, and acute care, team-based care was estimated to save 65 per cent of primary care provider time. Considering the immense time and resource pressures that have put primary care into crisis mode, this potential for massive lightening of physician load is not simply good timing but should be seen as a life preserver for the healthcare system.
But let’s move beyond the lightened load model that also strives for continuous and better patient care. It would, of course, be naïve to assume that simply composing a primary care team of health care professions X, Y, and Z assures better care. Rather, for a team to be of high value, each member must contribute high value care. As a healthcare-systems pharmacist, I inevitably ask the question of how a pharmacist practices high value care that compliments the care of the multidisciplinary team?
The significant role healthcare-systems pharmacy has in primary care provision has been documented repeatedly for decades, showing not only improved medication adherence, disease risk factor reduction but, more importantly, decreased hospitalizations and emergency room visits. These outcomes are a likely product of the pharmacist’s appropriately worn label of medication manager. While the role is unique, the skill set only becomes truly unique and essential when the pharmacist proactively seeks out high value care: the role of medication management master takes the stage. A master asks unique questions that others will not, to get to the heart of issues others have not, that lead to unique and essential solutions for patients that link with the needs of the team as a whole.
As a pharmacist in primary care, the baton being passed is often a diagnosis or clinical assessment. The next leg of the race, in order to be run effectively, requires the essential tenets of evidence-based practice to be put into action: understanding of best evidence, assessing the clinical scenario, and engaging in the unique values and preferences of the patient. The nuanced clinical judgment encompassing this paradigm by the pharmacist and, necessarily, the collective team results in the highest chance of providing high-value care. Bypassing this step or approaching it simply with passive reaction to the decisions or recommendations of others without using specialized insightful skill sets will increase the likelihood of low value (or no value) care. Hierarchies, assumptions, and a restrictive system can quickly result in reactive practice which tends to be neither essential for care for the patient, nor satisfactory for the practitioner.
Our best healthcare system models need to seek out what is both unique and essential. For a primary care team to provide high value care, the system around them needs to provide the space for the collective team to learn, adapt and flourish, capitalizing on the unique and essential features of each of its members that make care sharper, smoother, and more effective. Current systems will need to move beyond the satisfaction of delivering a concept developed at the boardroom table to ensuring true integration where all team members know how to optimally practice in their setting and have the support and space to adapt and innovate alongside each other.
Unique is interesting. Unique is fun. In primary care, being essentially unique as a healthcare-systems pharmacy professional is a necessity.
Dr. Jamie Falk is an associate professor at the College of Pharmacy, Rady Faculty of Health Sciences. He also practices as an extended practice pharmacist with the Department of Family Medicine at Kildonan Medical Centre in Winnipeg, MB.