Living the legacy of community care

“We know people before we know what their illnesses will be.”

The late Dr. Ian McWhinney, the founding father of family medicine in Canada, often spoke of the unique nature of general practice. 

“What we do is defined by the relationship with our patient,” explains Dr. Scott McKay, Chair/Chief of Family Medicine at St. Joseph’s. “We know a strong physician-patient bond improves care.”

Family doctors care for people ‘cradle to grave’, guiding patients throughout their health journey – a role many consider to be the backbone of the Canadian healthcare system.
But as patients across the country face issues accessing primary care, including a critical shortage of family doctors, the system is at a crossroads.

Faced with this complex challenge, leaders and providers at St. Joseph’s Health Care London are reimagining what primary care looks like and embracing new ways to deliver care and improve patient experiences.

“One of our guiding principles is that family medicine must prioritize the needs and values of the community,” says Dr. McKay. 

A long history of care

This community ethos has long been at the heart of St. Joseph’s mission to provide compassionate care and is reflected in its remarkable history as a leader in modern family medicine.

St. Joseph’s established a Department of General Practice in 1955 and it underwent several evolutions in the following decades. 

During the 1960s, there was a recognized need nationally for more general practitioners who could provide comprehensive and continuous care to patients. With concerns about the quality of general practice in Canada at the time, there was also an urgent need to develop postgraduate training programs in family medicine. St. Joseph’s was chosen as the clinical partner for the first such residency program at Western University – widely regarded as the birthplace of family medicine in Canada – because of its tradition of community involvement and well-established leadership in the discipline.

An outpatient program was opened at the hospital in 1968, which quickly expanded to become the St. Joseph’s Family Medical Centre. As the first full-service clinic of its kind in Canada, the Centre embraced community-based family medicine from its earliest days. 

A model of comprehensive care

Today, the Centre continues to serve as a model of comprehensive care, working in partnership with the Thames Valley Family Health Team to provide nurse practitioners, social workers, pharmacists, dieticians, occupational therapists, psychologists and other health care professionals who work with physicians as a team. 

In this interdisciplinary environment, providers are empowered to care for the whole person – body, mind and spirit. 

“We take pride in delivering patient- and family-centred care. This means treating our patients in their context, including their history, value systems, cultural needs and family dynamics,” says Dr. Laura Lyons, an academic family physician and Clinical Team Lead with the Centre. 

Other primary care programs at St. Joseph’s include the Regional Sexual Assault and Domestic Violence Treatment Centre and the Primary Care Diabetes Support Program, offering care, support and education for individuals diagnosed with diabetes, many who don’t have their own family doctor or are new Canadians, and a full-service dental clinic. 

Together with the Family Medical Centre, these programs support upwards of 10,000 patients annually. 

A vision for the future

Looking to the future, the vision is to develop a Centre of Excellence in Primary Care and Family Medicine. With an emphasis on people currently underserved in the healthcare system, the goal is to integrate the social determinants of health, such as housing and food, into care delivery – becoming a flagship program for social medicine.

“Because primary care is included at the highest level of planning and policy development at St. Joseph’s we are able to respond and adapt to community needs,” says Dr. Lyons.

This future vision also includes a Primary Care Teaching Unit to foster team-based care. While current programming at St. Joseph’s plays a key role in delivering education for family medicine, nursing and allied health professions, a dedicated teaching unit offers exciting opportunities for interdisciplinary training and research.

“By training learners in a dynamic, interprofessional environment, the hope is that more of them will want to practice in this way,” says Dr. McKay. “Incorporating research will support evidence-based practices and promote further innovation in primary care.” 

Throughout its history, St. Joseph’s has produced great leaders in family medicine and primary care – a legacy of excellence that lives on.

“We remember and we live the legacy; it weaves into our work everyday,” says Dr. McKay. “This is not only the birthplace of family medicine, but also a place that continues to innovate and evolve to improve care for patients in our community and across Canada.”