COPE is a CIHR funded ethnographic study designed to identify the complex patient with chronic pain from the standpoint of primary care health professionals, and to ground our investigation in their accounts of the work that caring for complex patients entails.
Patients with chronic conditions and multiple morbidities represent a growing challenge for health care globally. Improved coordination of care is considered essential for providing more effective and cost-efficient care for these patients with complex needs.  Osteoarthritis is one of the most common and debilitating chronic conditions, yet osteoarthritis care is often poorly-coordinated. Primary care is usually the first contact for patients requiring relief from chronic pain. Our previous work suggests discordance between the policy goals of improving patient care and the experience of patients. We plan to investigate the empirical context of the primary care setting by focusing on primary physicians’ conceptualizations and performance of their work in treating complex patients with chronic pain. This will allow for an exploration of how primary health care is – or could be – integrated with other services that play an important role in health. While there has been a great deal of attention paid to identifying the epidemiology of multi-morbidity and patient complexity, comparatively little attention has been paid to the processes of care that treating complex patients entails, and to identifying what high-quality, patient-centered care for these patients should look like in practice.
The Dalla Lana School of Public Health is a world leader in public health research, education and service. Its vision is to be the leading model for public health and health systems learning, research and service, with impact at local and global levels. The school believes in health systems scholarship built on engagement, excellence and impact.

In order to fulfill this mission and vision it will be important for the DLSPH to continue to invest thoughtfully in collaborative models that integrate decision-makers and institutions in government, civil society, the public and private sector, and community-based organizations, with the potential for population health and health systems impact.