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Dr. Terrence McDonald
July 5, 2024
At the O'Brien Institute for Public Health, we are privileged to work alongside some of the brightest minds in healthcare research. Our members are dedicated to advancing knowledge and developing innovative solutions that address the most pressing health challenges in Alberta and beyond.
We recognize that as Albertans, we are in unprecedented times as our healthcare system undergoes restructuring. In light of this, we are excited to launch O'Brien Institute’s Shaping the Future of Healthcare series, where we will be highlighting some exceptional researchers who are driving change and making a profound impact in the following key areas:
Each week, we will feature dedicated members from these categories, showcasing their groundbreaking work, achievements, and the positive influence they have on our community. These individuals exemplify the O'Brien Institute’s spirit of innovation, compassion, and excellence.
Join us in celebrating these healthcare research innovators and learning more about the incredible strides they are making to improve health outcomes for all Albertans. Stay tuned for inspiring stories, insightful research, and a glimpse into the future of healthcare.
Let’s honour the people behind the progress. Together, we can foster a healthier, brighter future.
Primary Care:
Primary care includes all of the services and resources we have as Albertans to support our daily health needs. Often times, it is our point of access to the healthcare system. Primary care is the foundation of our healthcare system, and it is important that all Albertans have equitable access to primary care. Read about some of our members who are transforming the quality and delivery of primary care in Alberta.
Dr. Terrence McDonald
Dr. Terrence McDonald: Ensuring continuity of care: Addressing family physician supply to inform policy
Dr. Terrence McDonald, MD, is a leading health services researcher in primary care. His research explores the supply of family physicians (FP), their practice patterns and the relationship between daily patient visit volume, provider continuity on health services utilization and patient health outcomes. Dr. McDonald’s research aims to inform current and future policy discussions on the design of the primary care system and physician payment model including how physicians are optimally remunerated for the patient care they provide.
The impact of continuity of care on patient health outcomes:
A recent study by Dr. McDonald and his team found that patients seen in primary clinics where multiple family physicians work together as a team and provide a ‘buddy-system‘ for caring for their patients had less emergency department visits.
There is extensive research on the benefits of physician continuity, but less is known is about the impact of clinic continuity on patient health outcomes and health system utilization. The trend of family physicians offering less direct patient care and choosing more part-time practice, coupled with a physician shortage and a growing population—many of whom are older and have multiple, complex health conditions—means that not all patients have access to their own family physician. Dr. McDonald’s research provides evidence to help policymakers design a primary care system that addresses the shortage of services by implementing team-based or shared care models within our communities.
Addressing concerns about the supply of family physicians:
In examining the supply of FPs in Ontario and Alberta using a service day methodology his team developed, Dr. McDonald found that while the number of FPs increased over time, many are providing less direct patient care. Furthermore, the number of new FPs (i.e., graduates) has declined and the supply of FPs has not kept pace with the growing and aging population. These findings are important because they highlight the gaps in the FP workforce and overall primary care model that need to be filled.
Why does this work matter?
Dr. McDonald’s research aims to address some of the major issues faced by many patients in Alberta and throughout Canada. The current shortage of family physicians creates major problems with access and continuity of care, which in turn places an enormous pressure on the health system including the inappropriate use of emergency departments for medical conditions normally managed by community family physicians. Through his research, Dr. McDonald aims to offer valuable insights into how best to address these issues and ultimately improve patient care, lower health systems costs, and reduce family physician burnout.
Dr. McDonald is a family physician and an assistant professor in the departments of family medicine and community health sciences. He is a member of the O’Brien Institute for Public Health.
Dr. Kerry McBrien (top) and Dr. Stephanie Garies (bottom)
Dr. Stephanie Garies and Dr. Kerry McBrien: Harnessing advanced technology to address social determinants of health in primary care
Dr. Kerry McBrien, MD, is a clinician researcher and associate professor in the departments of family medicine and community health sciences at the University of Calgary. Her research focuses on developing and evaluating innovative models of care that improve the quality and efficiency of primary care by addressing social determinants of health and overcoming barriers to care. She is the Co-Director of the Southern Alberta Primary Care Research Network (SAPCReN), alongside Dr. Stephanie Garies.
Dr. Stephanie Garies, PhD, is a primary care scientist and epidemiologist with the Department of Family Medicine at the University of Calgary. For over a decade, she has been involved with the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), the first and only pan-Canadian repository of primary care electronic medical record (EMR) data. Her research focuses on improving primary care data and outcomes through EMR data science, digital health, and artificial intelligence.
Using digital health tools & AI to understand and address social determinants of health in primary care
Our well-being hinges significantly on factors beyond healthcare, including socioeconomic status, housing, gender identity, race/ethnicity, and more—collectively termed social determinants of health (SDoH). While these factors profoundly influence health outcomes, healthcare providers often lack comprehensive information about social determinants for their patients. Drs. McBrien and Garies’ new research initiative aims to rectify this gap.
They are at the forefront of a novel project, aiming to enhance SDoH data in primary care by using a standardized electronic survey to capture this information from patients directly and by developing machine learning models to predict social need at an aggregate or regional level. This approach will support family physicians in the provision of tailored, comprehensive care for both social and medical factors, as well as enable better planning and resource allocation by health system leaders.
Why does this work matter?
Drs. McBrien and Garies’ research is vital as it addresses one of the most significant factors influencing health outcomes beyond the healthcare system itself: the conditions in which people are born, grow, live, work, and age. This innovative work has the potential to transform primary care by ensuring more equitable and effective healthcare delivery, ultimately improving health outcomes for diverse populations.
Dr. McBrien is an associate professor in the departments of family medicine and community health sciences. She is a member of the O’Brien Institute for Public Health. Dr. Garies is an adjunct assistant professor in the Department of Family Medicine. She is a member of the O’Brien Institute for Public Health.