Engaging Family Physicians in the Provision of Palliative and End-of-Life Care: Can We Do Better?

Background: Evidence shows the benefits of having a family physician (FP) at the heart of a care team that delivers palliative and end-of-life care (PEoLC). However, FPs have limitations on their ability to provide PEoLC. Objectives: We conducted a quality improvement study to (1) explore the barriers FPs encounter in providing PEoLC in our metropolitan context and (2) identify potential strategies to overcome these challenges. Methods: We interviewed a cohort of FPs from 10 different clinical practices within a metropolitan area (British Columbia [BC], Canada); this cohort is not regularly engaged with our Specialist Palliative Care Team. Verbatim transcripts were examined using inductive thematic analysis. Results: All FPs identified home visits as a critical aspect of being able to provide PEoLC. Despite this consensus, work-life balance, time, and compensation are major barriers to providing home visits and PEoLC. Local healthcare system awareness (available resources, why and how to access them) was identified as a barrier that can potentially be addressed through education sessions. Although 5 out of 10 FPs had not had formal palliative care education or training, clinical education was not considered a barrier to provide PEoLC. Conclusion: Providing FPs with tools and resources through education, including why and how to access them, and adjusting the BC compensation model to address home visit's travel time and time modifiers may better support FPs to provide PEoLC.