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Printed from: http://www.napcrg.org/Conferences/PastMeetingArchives/2017AnnualMeetingArchive/PlenaryPresentations


Plenary Session I: Health for All? Family Medicine Perspectives from Canada and the World

Ruth Wilson, MD, FCFP, CM

Dr. Margaret Chan, former Director of the WHO, says “I regard universal health coverage as the single most powerful concept that public health has to offer. It is inclusive. It unifies services and delivers them in a comprehensive and integrated way, based on primary health care.”  Barbara Starfield’s work has demonstrated how strong primary care systems contribute to better health outcomes, at lower costs.  Canada prides itself on the Canada Health Act and the legacy of Tommy Douglas-- insurance for all for medically necessary services, free at the point of access. How well is Canada doing, and what are the lessons from Canada and for Canada from other health care systems?


Plenary Session II: Indigenous Health and Wellness: Transformed With Community=Chosen Research and Interventions  

Elder Amelia Tekwatonti  McGregor; Ann C Macaulay, CM, MD, FCFP, FCAHS, FRCPC (Hon.); Shirley Bighead; Norma Rabbitskin, RN; Scott Krueger RD, CD, CDE; Alexandra K Adams, MD, PhD; Vivian R Ramsden, RN, BSN, MS, PhD, MCFP (Hon.)

Indigenous populations are at high risk for developing chronic diseases, e.g. diabetes, cardiovascular disease, cancer and HIV/HCV. In this session, we hope to raise the knowledge and awareness of ways in which research has been co-created with three Indigenous communities (two in Canada and one in the United States) and subsequently contributed to the health and wellness of the community. In addition, the communities will highlight the knowledge, skills and perspectives they brought to co-created research. Research that involves authentic engagement, co-creation and participatory research with individuals, organizations and/or communities is designed to improve health and wellness and to minimize health disparities. Narrative and results/findings that evolved from co-created, community-chosen research and interventions will illuminate the strengths and opportunities for change identified by the community. Thus, for community-chosen research and interventions to be successful, all aspects of the research process must be co-created, co-designed, co-implemented, co-presented and co-published; and, academic researchers must be co-facilitators.


Plenary Session III:  A State of Wonder: Research and the Real World


Don Berwick has raised recently the idea that medicine is moving into its third era. Era one, that of professional autonomy was characterized by protectionism. The second era, of accountability and market theory, was characterized by measurement and reductionism. This session takes the concept of the emergence of a third, Moral era of medicine and frames it for primary care research, using medication use and polypharmacy to provide a lens to examine strengths, implications and opportunities for primary care research.  

From system and from a patient perspectives there are key underlying questions that offer great opportunity: how will primary care research underpin the innovative systems of care needed for individuals to support a life worth living, on their terms?

Click here to download Dr. Mangin's PowerPoint presentation.

WONCA Presentation: A World of Opportunity -  But How to Choose?

Professor Amanda Howe, MD, MA, MBBS, BA; President World Organization of Family Doctors (WONCA)

Primary care is variously defined as setting, service and solution. As it focuses on individuals and communities, and covers the whole spectrum of health and illness from cradle to grave, almost any area of research is legitimate and may be relevant to some people. However, funders and academic institutions tend to set priorities to ensure money is spent on areas of population health need, and to favor traditional paradigms of randomized controlled trials and so-called robust experimental design. This can be in tension with qualitative approaches that focus on the unique range of experiences of individuals, and also with the need to evaluate innovations or changes in service delivery, which may be very variable and context dependent. Even more complex is the question of how to evaluate the same issue in different health systems. 

As President of the World Organization of Family Doctors, Prof Howe is well aware of the demands for evidence encouraged by WHO. Different constituents of the primary care research community try to make sense of issues such as impact of primary care workforce inputs, but differences in academic capacity and lack of a robust international infrastructure for comparative studies of health service interventions is a challenge to finding out ‘what work for who and why’? Using family medicine as the working example, Prof Howe will reflect on how we can add value to the collection of evidence through our international networks.