Closing the gap: physician brings family practice perspective to research project


Like most family physicians, Dr. Carrie Bernard has a busy practice, which she balances with an academic career and an active personal life. But that hasn't stopped her from adding on yet another role: one of the founding researchers for the i-GAP study, a project that fits perfectly with her passion for improving advance care planning (ACP) in primary care. 

The i-GAP study, a research project intended to increase the participation of health professionals and patients in advance care planning, has brought together researchers and practitioners with an exceptional knowledge of end-of-life, palliative care, primary care and advance care planning. Dr. Bernard's expertise and contacts with family practices across Canada adds the critical primary care perspective, as well as someone to champion the study to family physicians across the country. 

Despite the demands of both her practice and academic duties, Dr. Bernard has played an integral role in the study, from being part of the funding application writing team, serving on the Executive Committee to actively participating as one of the 'incubator' family practices. "To be honest, I was far too busy to think about doing this," she says. "I had a busy family practice, I had a leadership role relating to scholarship in family medicine at McMaster and soon into the grant writing for i-GAP, I took on an even larger leadership role at the University of Toronto. But ACP was SO important to me." 

A recent study has found that 86% of Canadians were interested in discussing advance care planning with their family physicians, and most wished to have these discussions while they were healthy.  Further studies, however, have revealed that the majority of family physicians and nurses don't feel comfortable enough or properly equipped to have these conversations.

Dr. Bernard knows firsthand the struggle that many patients and their families have with these discussions. "Too often I've had to support patients who were, for example, in conflict with siblings over the care of an aging parent," she says. "I knew the importance of ACP, but I was struggling to make it work in my practice. I wanted to find out why patients weren't following up after being provided with  information materials related to ACP.  That's why I made time for i-GAP."

The i-GAP team engaged with front line family doctors to build the study, and is working closely with them throughout the various research phases of identifying barriers to conversations and in evaluating the effectiveness of ACP tools and ways to implement ACP in practice.

Dr. Bernard believes that the i-GAP project is integral to improving health care in Canada, and she's also excited by the value that it brings to her patients. "By playing an integral role in the research project, I have the opportunity to help develop best practices for these types of conversations," says Dr. Bernard. "But I'm also using these tools to give my patients and their family members the opportunity to have these important conversations about their care. It's a win-win situation."


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