Rachael McKendry

Evaluation of the quality of patient information to support informed shared decision-making

Objectives (a) To find out how much patient information material on display in family physicians’ offices refers to management choices, and hence may be useful to support informed and shared decision‐making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians.

Legalized, regulated, but unfunded: midwifery's laborious professionalization in Alberta, Canada, 1975-99

In 1992, Alberta became the second Canadian province to legalize midwifery. This happened even though there were only approximately 20 midwives in practice at the time, and despite strong opposition from the medical and nursing professions. Between 1992 and 1999. Alberta established a regulatory framework for midwifery as a profession but. unlike Ontario and British Columbia, failed to pay midwives out of the provincial health care budget. This sent midwifery in Alberta into a crisis as many midwives closed their practices. This article first considers why midwifery was legalized and then professionalized in Alberta. Our answer emphasizes the leading role of state health bureaucrats in promoting midwifery as part of the states challenge to medical dominance. Second. the article addresses why midwifery received so little governmental support at the same time that it attained professional status. This analysis includes a comparison with how midwifery developed in Ontario and British Columbia. Our conclusion is that midwifery in Alberta became a victim in the post-1993 period when a new Right government set aside bureaucratic initiatives in health care and committed itself to major cuts in government spending.

Defining and measuring full service family practice in BC, 1991-2006

Background Ongoing primary care reform in Canada is in part a response to concerns that Canadians lack timely access to a regular source of primary care. While the supply of general practice physicians per capita has been stable, changes in practice patterns including abandonment of specific areas of practice (such as obstetrics, anesthesia, or provision of services in hospitals, homes, or long-term care facilities) and movement to walk-in style clinics may shape accessibility of primary care as perceived and experienced by patients. In British Columbia (BC), the General Practice Services Committee (GPSC) has spearheaded reform efforts. Founded in 2003, the GPSC is a joint committee composed of the BC Ministry of Health, the BC Medical Association, and the Society of General Practitioners of BC. Its mandate is to support full service family practice and benefit patients. This report seeks to operationalize the GPSC definition of full service family practice using administrative data, and to track changes in physician practice patterns consistent with that definition over time.