Winds of change

Evolution

I believe that the concept of evolution is an effective framework to reflect and create such change—and this is the theme I have chosen to build on during my presidency. For those who might be concerned, I have no intention of reopening the Scopes Monkey Trial! I am most partial to the definition of evolution as the “creative product of a vital force.”2 In other words, it is an active not a passive process. The College of Family Physicians of Canada, through its members, has an important role to play in determining the nature and direction of that evolution. As family doctors, we have an obligation to act as a “vital force,” ensuring that our system responds more effectively to the needs of our patients and those Canadians who are waiting to find family physicians.

We have evolved from a system in which the generalist was the norm (before the 1960s) to a system in which the generalist became less valued and subsequently endangered. And now we are moving to a place where the specialty of family medicine is recognized throughout the world for its benefit to patients and health outcomes. Our College must continue to push for changes in our health care system that respond to the needs of our patients; changes that acknowledge the toll that the simple act of waiting takes on our patients and their families; changes that categorically recognize the effectiveness and value that family doctors provide in health care delivery; changes that offer significant practice supports and enhanced remuneration to those family doctors, both urban and rural, who work tirelessly to provide care to their patients under difficult circumstances and are approaching burnout; changes that give more than lip service to the benefits of health promotion and prevention; changes that address the determinants of health.

Health inequality

Martin Luther King once said, “Of all the forms of inequality in the world, injustice in health care is the most shocking and inhumane.” Sometimes we as Canadians convince ourselves that because we have a publicly funded system we do not have inequalities. Of course, those of you who have worked in remote and northern communities, and even in the core areas of our cities, know that inequality exists. It is certainly less prevalent than in other countries, but our failure to effectively address the burgeoning health problems of disadvantaged Canadians is the elephant in the room; it is the constant reminder that if we wish to consider ourselves a caring, compassionate society, there is much to be done within our own country.

Resources

National Physician Survey statistics tell us that the manpower crunch will get worse before it gets better; we will see waves of retirements over the next decade. This—combined with the generational evolution toward a different work-life balance—will create an unprecedented resource problem. Creative solutions are needed during this time of stress. The College must continue to work with our sister organizations to ensure an appropriate mix of Canadian-trained and international medical graduates to deliver quality care to Canadians. The primary goal must always be quality care, not stopgap care. Quality must not only be ensured, it must be enhanced.

As President I hope to represent the values of family medicine and the many faces of family doctors across our country, effectively and passionately. My involvement with the College has enriched my life through the relationships I have formed and the many committed, astute, and creative colleagues I have met. I look forward to the coming year with great enthusiasm and hope. And I am exceptionally grateful for the opportunity.