‘The biggest lesson from the pandemic’: In conversation with Cambridge family physician Mekalai Kumanan

Picture of Dr. Kumanan

March 2023 marked the 3rd anniversary of the ongoing COVID-19 pandemic; Dr. Kumanan, president of the Ontario College of Family Physicians, speaks about lessons as it relates to family doctors in Cambridge, and Ontario

Article was updated 

 

The Ontario Medical Association (OMA) recently held a news conference in observance of the third year into the COVID-19 pandemic, and 20 years since the SARS outbreak in Canada.

While discussion focused on lessons from the pandemic, and the plan moving forward as we prepare for future pathogen threats, perhaps for the first time, long COVID was treated as a topic of national importance, with funding and support from the federal government.

The Cambridge Times spoke with Dr. Mekalai Kumanan, president of the Ontario College of Family Physicians (OCFP), and Cambridge family doctor on her thoughts about the lessons thus far, and the journey that lies ahead of the ongoing pandemic.

HOW HAS THE OCFP ADAPTED TO NEW KNOWLEDGE AND RESEARCH ON LONG COVID?

Long COVID is a relatively new condition that we have been dealing with. The OCFP provides educational tools and resources to our members who are family physicians across Ontario. Every few weeks, we offer a COVID community of practice with long COVID expert speakers so that our members can stay up-to-date. We also provide other educational supports so that all family physicians in Ontario can continue learning about long COVID.

HOW CAN PATIENTS APPROACH CONVERSATIONS WITH THEIR FAMILY DOCTORS IF THEY SUSPECT LONG COVID SYMPTOMS?

I would say that any patient who has had prolonged symptoms after a known or suspected COVID infection should seek their family physician for an assessment, even if they did not test positive for COVID.

WHAT KIND OF SYMPTOMS SHOULD PEOPLE WITH PREVIOUS INFECTIONS OR SUSPECTED COVID INFECTIONS SHOULD WATCH OUT FOR?

We know that symptoms can vary quite a bit. Long COVID can include fatigue, feeling unwell after exercise, changes or disruptions to routine sleep patterns, shortness of breath, poor concentration, and mental health symptoms like anxiety, and other mood changes. It can be worthwhile to see a family physician and seek assessment if a person is having prolonged symptoms that are bothering them.

WHAT IS THE BIGGEST LESSON FROM THE PANDEMIC AS A FAMILY DOCTOR?

We are seeing that patients are presenting with more complex medical issues over the years. Long COVID is one example of a very complicated medical issue that is often best addressed in an ongoing patient-doctor relationship, where a patient has a regular family physician providing care for them. What we have seen in the past few years is that we are facing a crisis in family medicine, where we have quite a large number of patients, but very few doctors.

Our most recent data shows that about 2.2 million people in Ontario do not have a family doctor. What we learned from the pandemic is that a family doctor plays a fundamental role in the patient care journey. There is growing evidence to support that when patients are connected to a family doctor, they have better health outcomes and greater life expectancies.

WHAT ARE SOME OF THE OCFP PRIORITIES GOING FORWARD?

A No. 1 priority is addressing the crisis in family medicine. There are a number of strategies we are pursuing, primarily recruiting family physicians, and increasing the capacity within the system in primary care.

These strategies are really important because when patients don’t have a family doctor, they often end up going to emergency, and this places added strain on the acute care system or the hospital system.

We also need to increase the amount of time that family physicians have to spend with patients. Reducing the administrative workload and expanding team-based care across the province would be effective ways of giving more time back.

Expanding team-based care across the province is particularly important especially when addressing patients who present with complex medical issues, such as long COVID, and that may require different types of care from different medical professionals.

Currently, only 25 per cent of family physicians work in a team-based care setting. We are aiming for 100 per cent of Ontario patients to be connected to a family physician who works in a team so that we can ultimately address the crisis that we are facing in family medicine.