Several recent experiences with patients in my family practice have given me cause to think deeply about the nature and challenges currently existing in Canadian medicine. I have been privileged to work for 16 years in rural practice followed by 20 years as a practicing academic physician with health education and systems experience on three continents. For many years I have worked with American colleagues and have had experience of working in America. Thus I have some 40 years of practice on which to reflect when helping patients navigate a complex health care environment. One advantage of my widespread geographical, social and temporal experience is the perspective it gives to my current work.

By and large, that perspective has been one of gratitude. Gratitude that I have been able to see some of my current patients for over 35 years.

The Provincial Primary Care and Cancer Network (PPCCN) was officially launched on October 30, 2008 and represents a powerful initiative and strategy of Cancer Care Ontario to engage primary care providers (Family Physicians, Nurse Practioners and Pharmacists (PCPs)) to become more involved in their patients’ cancer journey. The network consists of a Provincial Lead (Dr. Cheryl Levitt) and 13 Regional Leads representing the different Local Health Integration networks across Ontario. Strong clinical evidence supports the critical role of PCPs in improving clinical outcomes, patient experiences and quality of care from health promotion, prevention, screening and early diagnosis through to survivorship, recovery or palliative care.

Recognizing that screening rates for Colorectal Cancer in Ontario (the second leading cause of cancer related

In Canada, debate about reforming health care is driven by delayed access to specialists and procedures. Enhancing specialist intervention is not, however, the key to health care improvement. Countries with better primary care have better population health outcomes and lower health care costs, and the World Health Organization released a report in 2008 urging that primary health care be prioritized.(1,2)

Access to family physicians is inadequate in BC, as it is in all provinces. The perceived demands and complexity of full-service practice may promote family physician sub-specialization and employment in walk-in clinics. Alarmed by the trend away from full-service family practice, leaders in BC established the General Practice Services Committee (GPSC) with representatives from the Ministry of Health Services and the BC Medical Association