Responses

Tom Bailey

Dr Dixon-Warren has raised a number of important points related to current challenges in both family medicine education and practice. Many of these challenges are not unique to Canada and have been experienced by nations across the globe.

The recognition of family medicine as a specialty has been undertaken in many nations. Whether the term family medicine or general practice is used, it has been recognized that this is not a debate about generalism versus specialism. Acknowledging our discipline as a specialty is but a single step in re-energizing our discipline and elevating it to the status that it deserves alongside all other medical specialties.

We are not acknowledging generalism as a specialty but rather family medicine. And it is not generalists that will become specialists in the discipline but those who have demonstrated their knowledge, skills, and attitudes in the discipline of family medicine.

A defining attribute of the family medicine specialist will be to have expertise in attending to any patient for any problem. Other specialties have long claimed generalist skills as important parts of their specialities as well, making it clear that we do not own the territory of generalism exclusively—and also demonstrating that generalism and specialism can and do coexist within the same the same skilled physician. For family physicians though, expertise in generalism is not just another skill—it is the most critical skill and will be promoted as the core element that defines us.

The world is changing and we must change with it. Our College and the discipline of family medicine in Canada have repeatedly been recognized both in Canada and globally for achievements that have served to lead the way in the education, training, lifelong learning, and standards for practice for the physicians who are part of our discipline. Our challenge now is to strengthen the pride in our discipline, not only for the family doctors of today but also, especially, for those of tomorrow.

The specialty of family medicine looks forward to doing this and to helping to address the many challenges before us, including the important issues raised by Dr Dixon-Warren, such as our roles on emerging health care teams and ensuring appropriate remuneration for family physicians. Family doctors must be acknowledged as equals to their peers in the other specialties, as critical players in the delivery of health care services in Canada.