Commission on the Reform of Ontario's Public Services

� To provide a range of services at a lower cost, include other health professionals in the
FHTs (nurse practitioners, registered nurses, dietitians and midwives, for example).
Unlisted practitioners such as physiotherapists and massage therapists would also be part
of FHTs; however, their services would be provided on a cost-recovery basis.
Recommendation 5-63: Require Family Health Teams (FHTs) to accept patients who choose
them, and the FHTs should work with each patient to connect them with the most appropriate
constellation of care providers.
Recommendation 5-64: The regional health authority should establish incentives to
discourage Family Health Teams from referring patients to acute care.
Recommendation 5-65: Regional authorities should also be responsible for assigning heavy
users of the health care system to the appropriate Family Health Team (FHT). If, for example,
there are 300 heavy users within a region and three FHTs, the regional health authority would
try to steer 100 to each, so that no FHT is overburdened.
Recommendation 5-66: Because Family Health Teams (FHTs) will be responsible for patient
tracking, they will need to build a critical mass of an administrative arm to carry out this task.
This administrative arm should be shared among a number of FHTs.
Recommendation 5-67: Better after-hours care must be offered and telephone/Internet
services should direct patients to the most appropriate and convenient care provider.
Recommendation 5-68: All Family Health Teams must be encouraged to add more
specialists to their teams, which will reduce referrals and ease some of the complexities
of patient tracking.
Recommendation 5-69: The Ministry of Health and Long-Term Care should allow the
flexibility necessary for Family Health Teams to share specialists by permitting part-time
contracts.
Recommendation 5-70: All Family Health Team physicians must begin engaging in
discussions with their middle-aged patients about end-of-life health care.
Far too often, patients and their families are thrust into making these types of critical decisions
under duress, where a clear understanding of alternatives and consequences is essential and
the need to rapidly implement the patient’s wishes is required.
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