BCCFP’s Response to the CARGA 1 Report

The BC College of Family Physicians (BCCFP) welcomes the release of the Strengthening Primary Care in BC (CARGA Primary Care Report) and the government’s commitment to improving access, equity, and quality of care for everyone in our province.

In September, after a detailed review of the report, we shared several key observations and questions with the Ministry of Health.

Family Physician-Led Team-Based Care

According to the report, as of June 2025, almost one in four British Columbians remain without a primary care provider. This underscores the urgent need to establish effective family physician-led team-based care.

In a report from the College of Family Physicians of Canada (CFPC), 80 percent of people prefer to access primary care input through a family physician. In addition, those preferring family physicians were more likely to cite physician qualification (75 percent) as the reason for their preference.

A study in Alberta also showed that patients receiving care from family physicians in interprofessional teams led to 35 percent fewer emergency department visits, 30 percent fewer hospital admissions and 17 percent fewer appointments with non-family medicine specialists.

While the CARGA report highlights Community Health Centres (CHCs) as an area of future interest and growth, it is important to recognize almost 90 percent of British Columbians attached to longitudinal primary care, are attached to community-based family physicians. These family physicians must be meaningfully included when planning primary care reform, and supported to build effective team-based care in their own communities.

Reducing Unnecessary Admin Burden

Supporting family physicians to work to their full scope of practice requires deliberate action to reduce administrative workload. In our recent survey of 541 family physicians across BC, 92 percent agreed that reducing administrative burden would improve retention.

We’ve asked the Ministry to continue its work in this area – building on steps like eliminating sick notes – and to prioritize targeted investments in family physician-led models of team-based care that allow more time for direct patient care.

EMR Standardization and Digital Integration

Lack of electronic medical record (EMR) integration continues to be a significant barrier to coordinated care. 35 percent of family physicians identified improved EMR integration as one of the most impactful ways to reduce administrative burden.

We have asked the Ministry of Health:

• What concrete plans exist to standardize EMR systems province-wide, enabling seamless data sharing between family physicians, specialists, allied professionals, and administrative staff?
• How will digital tools be leveraged to reduce administrative burden and enhance the quality of care?
• How will digital enablement efforts align with the broader BC Digital Health Strategy’s goal to “create a consistent provider experience through the deliberate integration of digital tools, systems, and data,” thereby improving provider experience and capacity?
• How will these efforts effectively incorporate family physician input to ensure that integration aligns with the needs of its primary users?

Performance Measurement

With implementation targets for PCNs and UPCCs nearly complete, the report indicates a shift toward performance measurement and optimization.

We asked:

• Which dimensions will be measured - access, health outcomes, patient experience, cost effectiveness, or others?
• Will there be a transparent logic model guiding evaluation (identifying inputs, structures, processes, outputs, and outcomes)?
• How will these metrics ensure that quality - not just quantity or efficiency - is captured?
• How will equity and cultural safety be embedded in performance indicators?
• Are metrics on primary care provision outside of PCNs and UPCCs being explored?

Continuing the Conversation

BCCFP President Dr. Katherine Bell attended the FPSC’s engagement session at the recent Joint Collaborative Committees (JCC) Conference in preparation for the second CARGA Report. We hope the feedback outlined in our letter will inform ongoing discussions and future planning.

We value the Ministry’s efforts to strengthen primary care and look forward to continued collaboration to ensure every British Columbian can access compassionate, relationship-based and culturally safe care.