Jonathan Fitzsimon

Medical Lead, Renfrew County Virtual Triage and Assessment Centre.

[Jonathan Fitzsimon @DrFitzsimon]

Great to see our recent research featured on the front page of @TorontoStar today. It highlights the dramatic impact that not having a family doctor can have, particularly for patients with multiple chronic diseases, on their mortality risk, the level of ED and hospital use and the cost to the healthcare system.

@tor

https://t.co/JjILPOhSxM

[Jonathan Fitzsimon @DrFitzsimon]

Looking forward to sharing Ontario's progress on Primary Care with colleagues across the border this evening. @PC4AA @janephilpott

[Jonathan Fitzsimon @DrFitzsimon]

Our new study published in #HAScholar @Health_Affairs highlights the importance of the work being done by @janephilpott and @ONThealth to ensure that all Ontarians have primary care.

For patients with multiple chronic health conditions, not having a family doctor is a huge problem for them. It also has a major impact on our emergency departments, hospitals and the cost of our wider health care system. Everyone should have primary care and it is crucial to provide that care as quickly as possible to Ontarians with multiple chronic conditions.

Our work in @RenfrewCounty continues to provide innovative solutions to these challenging problems.

Thanks to @DrMichaelGreen1 @DrSarahJCook @tara_kiran and many others for supporting this work.

[Allan Grill @allan_k_grillMD]

R/T ⁦@Megan_Ogilvie⁩: “The study…found the first five years after individuals lose a family doctor have higher odds of death compared to those who have a long-term relationship with their physician.” ⁦@DrFitzsimon⁩
https://t.co/q42mvho1fn
https://t.co/sU0VxGqSeA

[Jonathan Fitzsimon @DrFitzsimon]

Thanks Eric. Always room for improvement!

We partnered with Healthcare Excellence Canada to produce resources for patients to help them better understand the nuances of the IVC model. Right from enrollment.

We had around 5% of IVC patients report challenges with the tech (mostly video appointments) so we increased options for supported appointments at the local clinic. Patients can come to the clinic and staff set up the video encounter with their family doctor plus a nurse can attend in-person in real time to help out if needed.

We’re constantly looking for ways to improve IVC though and the ongoing evaluations will help us do that. I appreciate everything I learned from you over the years, especially the concepts of putting patients first and always striving for excellence.

[Jonathan Fitzsimon @DrFitzsimon]

Powerful evidence published today, demonstrating the success of Integrated Virtual Care (IVC), the attachment arm of @rcvtac.

https://t.co/XCvdgoouck

"High levels of satisfaction, strong physician trust and a positive overall experience. These findings support the potential of models like IVC to address Family Physician shortages, particularly in rural areas."

Residents without primary care are formally attached to a family doctor who works remotely but is embedded in a local family health team. Patients then receive comprehensive, team based care through a hybrid of in-person and virtual care options. Hundreds of IVC patients completed detailed questionnaires, so that we could analyze their experiences. Since we did this work, IVC now enables over 6000 previously unattached residents of @RenfrewCounty to have a family doctor and a primary care team.

Our team, supported by @tara_kiran, Judy Belle Brown @westernuFamMed @SavoirMontfort @UofODFM and many others, will soon be publishing further evidence of the success of the IVC approach, with papers on clinician and non-clinical staff experience, factors impacting physician choices to join IVC, and a major study evaluating the clinical and economic impact of IVC, using Ontario's population level health databases.

As @SylviaJonesMPP and @ONThealth legislate the commitment to all Ontarians being attached to a primary care team and @janephilpott leads the work to deliver this, one of the main challenges (highlighted by @OntariosDoctors) will continue to be supporting rural and northern communities who often struggle to recruit family doctors to physically relocate there.

I hope that the evidence behind IVC will support ground breaking innovations using hybrid approaches of in-person and virtual care. IVC has delivered the promise of primary care attachment to thousands of some Ontario's most vulnerable people and has the potential to do the same for thousands more.

@OntarioCollege @OCFP_President @donohueranch @PeterEmon1

[Jonathan Fitzsimon @DrFitzsimon]

Our new research, published today in BMC Primary Care, details the substantial impact of unattachment (the lack of any formal enrollment with a primary care provider) on both individual patients and the healthcare system. https://t.co/KE9A6waFeZ

We can now define the disparities in healthcare utilization and costs in Ontario, based on comorbidities, attachment status and unattachment duration. Attached residents with low comorbidities had a median total annual healthcare cost of $287. Annual costs for long-term unattached individuals with high comorbidities rose to $8,177, a staggering 2849% increase.

This research further highlights the importance of the work of @janephilpott and Ontario’s Primary Care Action Table, in ensuring that all Ontarians have attachment to a Primary Care Provider and access to a Primary Care team.

More work from our team should be published very soon, highlighting the success of the ground breaking innovations in @RenfrewCounty, using a hybrid of in-person and virtual care options to attach residents to a family doctor and provide access to a local team of interdisciplinary health professionals.

@SylviaJonesMPP @ONThealth @OntarioCollege

[Jonathan Fitzsimon @DrFitzsimon]

Lots more research and work in the pipeline from our team and colleagues on the impact of unattachment duration and of gaining and losing attachment to primary care.

https://t.co/HnMfuMv4My

[Jonathan Fitzsimon @DrFitzsimon]

After the tremendous announcement of $1.8B for primary care in Ontario from @SylviaJonesMPP and @janephilpott yesterday, it is perfect timing for the publication today of our paper on the impact of changes to primary care attachment. https://t.co/19Lhe5fZdO

[Kevin Mcleod @dockevinmcleod]

I am having to add “lack of access to primary care” as a medical problem on discharge for more and more complex patients. This worsens patient outcomes and ends up costing you a lot more in tax dollars in the long run.

[Dr. Nina Ahuja @ninaahujamd]

Happy National Physicians’ Day. In Canada, May 1st recognizes the dedication, compassion, and expertise of physicians. Thank you to my colleagues for your commitment to patient care. #NationalPhysiciansDay

[uOttawa Salle de presse l Newsroom @uOttawaMedia]

Innovative healthcare program by @DrFitzsimon @UofODFM @uOttawaMed Cayden Peixoto @SavoirMontfort #uOttawa successfully paired residents with family physicians to highlight how integrated virtual care delivers primary care to remote communities

https://t.co/XNN0ARSAH7

#uOttawa

[Jonathan Fitzsimon @DrFitzsimon]

This report makes depressing reading for all Canadians. A high functioning primary care system needs a strong, dynamic, motivated cadre of family doctors. Family medicine is a vital medical specialty, fundamental to the health, wealth, productivity and wellbeing of our nation.

[Kwadwo Kyeremanteng @kwadwo777]

We got some work to do.
Couple thoughts:
Leverage virtual care to improve access (@DrFitzsimon ).
National licensing.
Proper compensation.
Leverage NPs, pharmacists etc when appropriate.

[Kwadwo Kyeremanteng @kwadwo777]

We got some work to do.
Couple thoughts:
Leverage virtual care to improve access (@DrFitzsimon ).
National licensing.
Proper compensation.
Leverage NPs, pharmacists etc when appropriate.

[Jonathan Fitzsimon @DrFitzsimon]

Integrated Virtual Care - the attachment arm of @RCVTAC, taps into unused capacity in the existing family doctor workforce. 18 have part-time IVC practices, so 6000 previously unattached residents of @RenfrewCounty now have a family doc + team based care.
https://t.co/nteWb2sybF

[Bill Ackman @BillAckman]

Take a look at New Yorkers in 1930 after a decade of economic exuberance. There were no gyms, SoulCycles, yoga classes, or running shoes.

There were no diets, Ozempic, USDA pyramids or degrees in nutrition science.

Yet, look at how lean everyone is. There is no obesity.

Makes you wonder about the food and soft drink industrial complex and our government’s oversight of our citizens’ health.

[Jonathan Fitzsimon @DrFitzsimon]

I used to think of sanitation as referring to keeping human and animal waste out of our contact.

We are now awash with pesticides, plastics and pollutants.

Health and well-being cannot exist alongside a polluted, toxic and unsanitary environment.

[Jonathan Fitzsimon @DrFitzsimon]

Strong connections with family, friends and community play a vital role in health and wellbeing.

Loneliness is associated with higher rates of many mental health conditions, including depression and Alzheimer's disease.

Health and well-being cannot exist alongside loneliness.

[Jonathan Fitzsimon @DrFitzsimon]

@kmoranONT @OntariosDoctors @RelayMD is making a good start on this, at least by showing availability and wait time.

The next steps would be to make it available to all doctors and to remove this obstacle of a referral being refused because of the patient’s postal code being in the “wrong” part of Ontario!

[Jonathan Fitzsimon @DrFitzsimon]

When I was growing up, I associated "malnutrition" with pictures of starving children in Africa.

Now, the destructive impact of ultra-processed food alternatives is felt across the world.

Health and well-being cannot exist alongside malnutrition.