Looking back and looking ahead

Rob Boulay

Memory is a child walking along a seashore. You never can tell what small pebble it will pick up and store away among its treasured things.
Pierce Harris

This is the last missive that I will write during my tenure as President of the College of Family Physicians of Canada (CFPC). What a privilege it has been to communicate with family doctors through this medium for the past 12 months. Indeed, the entire year has truly been a remarkable experience for a small-town boy from Miramichi, NB. I have had the honour of meeting and interacting with countless colleagues, leaders from other specialties and medical organizations, representatives from other health professions, and provincial and national policy makers. And then there were the patients, who told me their stories of good and sometimes not-so-good experiences. Although I sometimes felt out of my depth, I always received an exceptional level of support from our CEO, Dr Cal Gutkin, our senior leadership team, our College staff, and our CFPC leaders. I have been repeatedly bolstered by the stories I have heard from other family physicians—how they put their hearts and souls into their daily work, often making immense personal sacrifices in order to care for their patients. I have also been amazed by their ingenuity, perseverance, and resourcefulness; they always seem to find ways to create and fund new initiatives, as well as build teams of professionals that can best fulfill their patients’ needs.

I want to reflect on a few things that were reinforced for me through my experiences this year; although they are not surprising, I certainly think that they bear mentioning.

I have said on many occasions that this is a very good time for family medicine; this is a statement borne out by the many conversations I have been a part of this year that have confirmed the value of our contribution to health care sustainability. It seems to me that, at long last, the focus of health care policy is shifting toward the work that family doctors do. With this increased attention, however, comes an increased responsibility to help lead the transformation of primary care. We must be at the table as issues of quality and access are discussed, and we must be prepared to defend the importance of a continuous relationship in a comprehensive family medicine setting to ensure the best possible health outcomes for our patients.

Access to health care is the most important thing to Canadians. Although we have made great strides in this regard over the past few years, there are still millions of citizens who report that they have difficulty obtaining the services of a family doctor. As we become involved in the conversation regarding quality, we must remember that there can be no quality at all if there is no access, and we must also be aware that quality is only a part of equality. The Canadian health care system should be able to guarantee equitable access to family medicine for all, regardless of geography or socioeconomic status.

As technology continues to change the way we practise our art, we must remember the central role that relationships play in our daily work. The power of the stories that our patients tell us and the bonds of trust and respect that we build with them form the foundation for the continuity of care that confers upon them better health outcomes. Whether we are working in rural areas or in the downtown cores of our largest cities, we cannot lose sight of the importance of this most human of experiences.

We owe a huge debt of gratitude to the people who love us: our spouses and partners, our children, and our parents. They see us at our most vulnerable and fragile times and offer us their endless support. I owe a particularly heavy debt to my own family—my wife, Bernadette, and my children, Daniel, Emma, and Samuel—for their love and understanding, as the CFPC occupied much of my time over the past year.

The CFPC is a strong organization whose vision will be a guiding light for the future of health care in this great nation. I am honoured to have been its humble servant for this brief moment in time.

Thank you for the memories.