Lack of early identification of patients owing to differing definitions of palliative population

Persistent lack of designated and dedicated coordinators or navigators to oversee organization, support case finding (patient rostering), and coordinate best practices across relevant care sectors

Lack of sufficient expert medical palliative care resources to assist family physicians with the provision of care (timely and consistent access, eg, after hours)

Lack of appropriate tools that allow family physicians to provide best practices care in home and community settings

Inconsistent or nonexistent application of outcome-based, EOL care domain assessment tools

Lack of skilled psychosocial, spiritual, and bereavement supports for EOL patients and families living in these communities

Lack of timely respite care, necessitating unwanted and undesirable hospital admissions and emergency room visits

Lack of timely communication and flow of information in a manner that allows family physicians to remain the key providers of continuous care

Lack of mechanisms that allow family physicians, in the context of their own office “teams,” to interact and collaborate directly with community palliative care team providers

Inability to model comprehensive palliative care, including best practice skills, knowledge, behaviour, and resources, for medical students and family medicine residents, owing to lack of structured contacts and resources

Lack of opportunities for practice-based continuing education utilizing academic detailing to develop best practices and collaborative skills

Lack of opportunities and resources (eg, salary replacement dollars) for mentorship, role modeling, and development of family physician practice “leads” who can be trained in turn