Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
OtherCollege

Communities and primary care reform

Tom Bailey
Canadian Family Physician April 2007, 53 (4) 777;
Tom Bailey
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading
Figure

Three months ago in this space I wrote about continuity of community. I outlined how each of the 4 principles of family medicine relates to community.

Physicians in general, and family physicians in particular, represent a community within a community. We represent a “body of people in a learned occupation.” But as individuals, we physicians also live in a particular location and share many of the cultural characteristics and interests of our local community. Just as a patient-physician relationship builds on repeated contact over time, so too will the relationship between physician and community, creating what one might call a “community-physician relationship.” Sharing life within the community creates mutual bonds between physician and community—separate from the role of physician.

The community often values the family doctor’s professional role more highly than individual physicians do. Value and respect might be expressed before a family physician even arrives in a community, especially a community that has been without a family doctor! But with that respect comes great expectation.

Communities thrust a responsibility upon physicians, and this is not simply because physicians belong to “a learned body”—many other professionals who are highly trained and knowledgeable are not expected to serve their communities as physicians are expected to. Physicians are expected to use their knowledge and skills for the betterment of the population—both of the community at large and of the people who comprise the community.

Where family physicians are in short supply, inevitable strains will be placed on the relationship between physician and community—strains that can escalate into conflict. Expectations of the community can exceed the capacity of individual physicians to meet them. Physicians can feel forced by circumstance to restrict services in some way. Such restrictions might not only reduce the scope of services that can be offered patients, but also reduce the respect communities have for physicians.

Of course, there are likely many possible solutions to this kind of conflict. There have been increases in resources provided for family doctors, through health transition funds, chronic disease management supports, information technology, and increased medical school enrolment (to name a few). Although such changes have been important, reforms have not yet addressed the core needs for some family doctors. And the changes have not always met the core needs of communities.

Many of the proposed solutions have been developed or negotiated in good faith at a high level—by institutions, organizations, or governments—but few of them have had an immediate effect. Solutions are often seeds that will take some time to flourish; for example, the effects of increased medical school enrolment will not be felt at the community level for some time (ironically, however, the increase has placed more strain on community teachers of family medicine and other specialty disciplines). Another example is the deployment of electronic medical records, which takes some time to benefit physicians and patients.

In some cases, solutions have not seemed flexible enough to permit effective implementation at the community level, while in other cases, strategies have not been effectively communicated to the community level. And many physicians have been so busy providing services to the patients in their community that they have been unable to take the time to identify and articulate their own needs or to consider what solutions have been offered.

As many traditional models of care are eroding, helping family physicians to meet the needs of their patients becomes more urgent: flexible models must allow family physicians to provide a broad scope of needed services and support for their patients in their communities. The model most likely to be effective is one that is based on global principles but is developed locally with the input and support of both community members and health service providers.

Family physicians with a deep understanding of the health care system, of community bonds, and of local values are well positioned to lead in the continued dialogue toward a more sustainable health care system. A system can sustain both the health of the community and the health of its health care providers!

  • Copyright© the College of Family Physicians of Canada
PreviousNext
Back to top

In this issue

Canadian Family Physician: 53 (4)
Canadian Family Physician
Vol. 53, Issue 4
1 Apr 2007
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Communities and primary care reform
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Communities and primary care reform
Tom Bailey
Canadian Family Physician Apr 2007, 53 (4) 777;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Communities and primary care reform
Tom Bailey
Canadian Family Physician Apr 2007, 53 (4) 777;
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • Les communautés et la réforme des soins de première ligne
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

College

  • 1361 raisons de garder espoir
  • 1361 reasons for hope
  • Importance of spatial design to team-based learning and care
Show more College

President's Message

  • Primary and secondary care
  • Toward a patient-centred health care system
  • Be mine
Show more President's Message

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • RSS Feeds

Copyright © 2023 by The College of Family Physicians of Canada

Powered by HighWire