About three years ago, I reduced my home care of the elderly practice radically, and most of the patients were taken over by a program called “HomeVIVE”, operated by Vancouver Coastal Health, comprising three family physicians and a nurse case manager visiting people at home.

Coincidentally, in the last few months, two things that happened: 1) I have rejoined the practice as a minor player (and another family physician has joined as well), and 2) Vancouver Coastal Health has upgraded the program to include especially frail people, with the stated objective of keeping these people out of acute and long-term institutions, and with significantly beefed-up staffing and resources.

HomeVIVE is still oversubscribed . There are many people waiting to be seen, and a waiting list of several months.  But the program now looks like the kind of basis on which a real comprehensive full-time primary care practice for frail people at home can be built.  It’s a genuine realization of a dream for many of us, although definitely still a work in progress. More to come.