Physicians have legitimate fears about both loss of clinical and other autonomy as well as loss of income. There is, moreover, a lack of leadership and a lack of creative proposals for change. It would be a significant adjustment for many physicians to move into multi disciplinary Primary Care Groups. They need to understand why new methods of practice would be better for them and would reduce or eliminate many of the frustrations they currently experience. Control over funds and funding will also be a major potential flash point requiring resolution.
Pilot projects draw out the process and each pilot can be studied endlessly.
Rather, in our view, there should be province-wide implementation in each province as reform occurs. A deadline should be set and implementation started immediately. In order to remove barriers to implementation we recommend that firm deadlines be set. A window should be opened and broad criteria and parameters set and then local providers should be invited to organize themselves into Primary Care Groups which, in turn, will be part of Integrated Health Systems. The window should remain open for sufficient time to allow providers to determine if they wish to participate and to organize themselves accordingly.