Annual Complex Care Planning Visits with your Family Physician

Dr. Daniel Ngui, BSc (P.T), MD, CFPC, FCFP, Family Physician, discusses Annual Complex Care Planning Visits with your Family Physician”

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Dr. Daniel Ngui, BSc (P.T), MD, CFPC, FCFP, Family Physician, discusses Annual Complex Care Planning Visits with your Family Physician”
Video transcript

Featuring Dr. Daniel Ngui, BSc (P.T), MD, CFPC, FCFP

Duration: 3 minutes, 33 seconds

So complex care planning in a family physician's office is ideally done with a patient, their family, and their family doctor who's known them for a long while and has the responsibility for ongoing care.

The type of visit that would occur would be a one-to-one visit with a family member, a health representative, over a 30-minute period, where we talk about medical conditions and plans for future care.

Your family physician will invite you for a complex care visit, but if you have any of the following combinations of diseases you may speak to your family doctor about making an appointment. So for example if you have diabetes, if you have chronic kidney disease, that would be a reason to speak to your family doctor about a complex care visit.

The other conditions include heart failure, a chronic pulmonary disorder such as asthma or COPD, cerebral vascular disease or ischemic heart diseases such as angina or chest pain with exercise. The other conditions include a neural degenerative disorder such as Alzheimer's disease. And finally a chronic liver disease would qualify for you speaking to your family doctor on a one-on-one visit.

So during the face-to-face complex care plan your family doctor will take the time to review your medical condition, your medications, your current therapies with you, your health representative, or your family, and discuss what are your individual patient goals and values and as well how can you link up with family services to support you in your long term care.

By the end of the complex care visit you should walk away with a summary of a plan of action for your long-term healthcare needs. That summary should include the medical diagnosis, the current therapies, it should incorporate what the patient's wishes, personal values and goals are and it should have specific and re-evaluation dates and linkages with community supporters.

As well what will happen at the end of the visit is your family doctor may choose to discuss with you end-of-life issues when clinically appropriate. End-of-life issues is a very difficult topic to discuss amongst patients and amongst patient's family.

However, your family doctor is ideally suited to compassionately convey and plan for future occurrences. During advanced care planning your family doctor may discuss with you a no-cardiopulmonary resuscitation form or introduce you to concepts of a health representation agreement.

These health representation agreements are providing a designated temporary decision maker when a patient is incapable of providing feedback or directions for their care. So complex care planning provides an ideal situation where you, your family, or health representatives can be involved with planning for your future care, and the end of your complex care visit with your family doctor you should come away with a very clear idea of what will happen.

A written summary will cover your current problems, your current therapist, what your future plans are, as well as linkages with community supports. So speaking to your family doctor is essential about complex care planning.

This patient educational video is for informational purposes only. Each patient has unique needs and unique concerns so it's very important that you seek help from your family physician or healthcare provider to review your own problems and issues.

Presenter: Dr. Daniel Ngui, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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