The impact of care of the elderly certificates of added competence on family physician practice: results from a pan-Canadian multiple case study.
Added competence
Credentials
Enhanced skill
Family medicine
Geriatrics
Health policy
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
07 11 2022
07 11 2022
Historique:
received:
01
05
2022
accepted:
12
10
2022
entrez:
7
11
2022
pubmed:
8
11
2022
medline:
10
11
2022
Statut:
epublish
Résumé
Family physicians serve an important role in the care of older adults, and have variable levels of training and comfort navigating this complex patient population. The Care of the Elderly (COE) Certificate of Added Competence offered by The College of Family Physicians of Canada recognizes family physicians with advanced expertise in older adult healthcare. We explored how COE training and certification impacts primary care delivery to older patients, including factors that impact group practice. We conducted a secondary analysis of multiple case study data to explore similarities and differences within and across cases. We defined cases as a practice or collective of family physicians working within a defined group of patients in an interconnected community. We analyzed semi-structured interview transcripts (n = 48) from six practice groups of family physicians across Canada using conventional (unconstrained, inductive) content analysis. We identified similarities and differences in how COE family physicians function within their group practice and the broader healthcare system. In some cases, COE certifications increased patients' access to geriatric resources by reducing travel and wait times. Some physicians observed minimal changes in their role or group practice after earning the COE designation, including continuing to largely function as a generalist. While family physicians tended to highly value their COE CAC, this designation was differentially recognized by others. Our findings highlight the impacts and limitations of COE training and certification, including an opportunity for COE family physicians to fill knowledge and practice gaps. As the number of older adults in Canada continues to grow and increasingly rely on primary care services, COE family physicians are uniquely positioned to strengthen the health system's capacity to deliver specialized geriatric care.
Sections du résumé
BACKGROUND
Family physicians serve an important role in the care of older adults, and have variable levels of training and comfort navigating this complex patient population. The Care of the Elderly (COE) Certificate of Added Competence offered by The College of Family Physicians of Canada recognizes family physicians with advanced expertise in older adult healthcare. We explored how COE training and certification impacts primary care delivery to older patients, including factors that impact group practice.
METHODS
We conducted a secondary analysis of multiple case study data to explore similarities and differences within and across cases. We defined cases as a practice or collective of family physicians working within a defined group of patients in an interconnected community. We analyzed semi-structured interview transcripts (n = 48) from six practice groups of family physicians across Canada using conventional (unconstrained, inductive) content analysis.
RESULTS
We identified similarities and differences in how COE family physicians function within their group practice and the broader healthcare system. In some cases, COE certifications increased patients' access to geriatric resources by reducing travel and wait times. Some physicians observed minimal changes in their role or group practice after earning the COE designation, including continuing to largely function as a generalist. While family physicians tended to highly value their COE CAC, this designation was differentially recognized by others.
CONCLUSIONS
Our findings highlight the impacts and limitations of COE training and certification, including an opportunity for COE family physicians to fill knowledge and practice gaps. As the number of older adults in Canada continues to grow and increasingly rely on primary care services, COE family physicians are uniquely positioned to strengthen the health system's capacity to deliver specialized geriatric care.
Identifiants
pubmed: 36344937
doi: 10.1186/s12877-022-03523-4
pii: 10.1186/s12877-022-03523-4
pmc: PMC9641851
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
840Informations de copyright
© 2022. The Author(s).
Références
Can Geriatr J. 2013 Sep 04;16(3):114-9
pubmed: 23983827
Can Geriatr J. 2012 Sep;15(3):68-79
pubmed: 23259019
BMC Health Serv Res. 2020 Apr 29;20(1):365
pubmed: 32349738
Can Geriatr J. 2018 Mar 26;21(1):6-13
pubmed: 29581816
Can Fam Physician. 2010 Nov;56(11):1101-5
pubmed: 21075984
PRiMER. 2019 May 31;3:15
pubmed: 32537586
Can Fam Physician. 2016 Dec;62(12):e749-e757
pubmed: 27965351
Can Fam Physician. 2018 Feb;64(2):155-156
pubmed: 29449247
Can Geriatr J. 2011 Jun;14(2):34-9
pubmed: 23251310
Can Fam Physician. 2015 Jul;61(7):601-6
pubmed: 26380850
Qual Health Res. 2003 Jul;13(6):871-83
pubmed: 12891720
J Gen Intern Med. 2004 Jun;19(6):708-9
pubmed: 15209611
Can Geriatr J. 2013 Dec 03;16(4):192-5
pubmed: 24278096
Qual Health Res. 2005 Nov;15(9):1277-88
pubmed: 16204405
Fam Med. 2003 Jan;35(1):42-4
pubmed: 12564863
Can Fam Physician. 2014 Nov;60(11):e521-6
pubmed: 25551143
Can Fam Physician. 2009 May;55(5):510-1.e1-4
pubmed: 19439709
J Am Geriatr Soc. 2006 Mar;54(3):512-9
pubmed: 16551322
CMAJ Open. 2021 Nov 9;9(4):E966-E972
pubmed: 34753785
SAGE Open Nurs. 2018 Sep 12;4:2377960818797251
pubmed: 33415204
CMAJ Open. 2017 Dec 19;5(4):E856-E863
pubmed: 29259018
Can Geriatr J. 2020 Sep 01;23(3):219-227
pubmed: 32904648
Can Fam Physician. 2012 Aug;58(8):e436-41
pubmed: 22893345
Sports Med. 2022 Aug;52(8):1983-1989
pubmed: 35294749
J Am Med Dir Assoc. 2010 May;11(4):231-8
pubmed: 20439041
Can Geriatr J. 2013;16(1):1-2
pubmed: 23441141
Health Aff (Millwood). 2019 Apr;38(4):624-632
pubmed: 30933575
Can Fam Physician. 2019 Jan;65(1):39
pubmed: 30674512
Health Aff (Millwood). 2002 Sep-Oct;21(5):78-89
pubmed: 12224911
Can Fam Physician. 2018 Feb;64(2):160
pubmed: 29449251
Can Geriatr J. 2014 Jun 03;17(2):53-62
pubmed: 24883163
Can Fam Physician. 2015 Mar;61(3):e148-57
pubmed: 25932482
Can Fam Physician. 2018 Jul;64(7):520-528
pubmed: 30002030
CMAJ Open. 2019 Feb 28;7(1):E124-E130
pubmed: 30819692
CJEM. 2022 Aug;24(5):473-475
pubmed: 35415764
Can Fam Physician. 2011 Jun;57(6):739-40, e237-8
pubmed: 21673223
Healthc Policy. 2014 May;9(4):32-47
pubmed: 24973482
Can Fam Physician. 2010 Jun;56(6):e219-25
pubmed: 20547504
CMAJ Open. 2022 Jun 21;10(2):E563-E569
pubmed: 35728839
Gerontologist. 2002 Dec;42(6):835-42
pubmed: 12451165