Advocating for family medicine

Cal Gutkin

As the voice of family medicine in Canada, the College of Family Physicians of Canada’s (CFPC’s) mission and goals include championing quality care for all people in Canada and ensuring that the role of the family physician is well understood and widely valued.

To achieve this, the College and its Chapters are committed to advocating for family medicine and family physicians throughout Canada. Our messages to all audiences—governments, media, medical students, peers, and the general population—emphasize the evidence-based value of all Canadians having personal family doctors who provide and coordinate a comprehensive range of services for them throughout their lives.

Our communications focus on the benefits of these family doctors working, wherever possible, with teams of health professionals and in practice settings equipped with electronic medical records and booking systems that ensure timely appointments. We encourage strong links between family practices and other medical services in each community, including hospitals, diagnostic testing facilities, and other specialists, to facilitate access for patients needing care outside the family practice setting. These elements are incorporated in the patient-centred medical home model, introduced in 2009 by the CFPC and now starting to be realized through outstanding leading-edge initiatives across Canada, such as family health teams in Ontario and primary care networks in Alberta.

We also remind our publics that family medicine is a comprehensive and complex discipline equal to any other medical specialty. It requires its physicians to complete a minimum of 6 years of medical school and postgraduate training and to demonstrate, through a national examination or equivalent assessment program, competencies in our discipline. Those who succeed are awarded Certification (CCFP) in the specialty of family medicine—a designation that must then be maintained through a program of lifelong learning. As decreed by federal government charter, the CFPC is responsible for establishing accreditation standards for family medicine residency, conducting Certification examinations, granting Certification to successful candidates, and setting standards for continuing medical education and maintenance of Certification programs for Certified family physicians throughout Canada. It is important that all stakeholders understand that the CFPC plays the same role for family medicine specialists that the Royal College of Physicians and Surgeons of Canada plays for specialists in other disciplines.

Our message to all is that family physicians should be valued and respected equally to other medical specialists and should be recognized in a manner that reflects the high value Canadians attribute to them. Whether related to teaching and leadership roles in our medical schools or remuneration for provision of clinical services, disparities between family physicians and other specialists must be eliminated. Until equity is realized, challenges recruiting and retaining enough family physicians to meet the needs of our population will continue.

It is also important that all stakeholders, including health system planners, understand that although family physicians are vital providers of primary care services, the role of family doctors goes beyond primary care alone. Unlike other primary care health professionals, family physicians are educated and trained to diagnose, treat, understand, and coordinate care for a comprehensive spectrum of medical conditions that require primary as well as secondary and tertiary levels of care. Patients need and benefit from treatment by many other primary care providers, but none of those providers are trained to be medical doctors and they should not be expected to replace the role of family physicians.

The CFPC leaders recently held 2 days of meetings on Parliament Hill with Members of Parliament, Health Canada officials, members of the Standing Committee on Health, and Opposition Party leaders and their health critics. Discussions focused on improving access to care by ensuring a family doctor for every person in Canada and supporting medical home practice models; concerns about sustainability of our health system and the need for ongoing support when the Health Accord ends in 2014; the needs of underserved populations; the importance of prevention and health promotion; and the need for better access to care for children and those with mental health problems and chronic diseases. While recognizing the important provincial role in the delivery of health services, we maintained that the federal government must not abandon its leadership role in ensuring the best possible health care and outcomes for all Canadians, regardless of where they live. To hide in the shadow of provincial responsibility is not leadership and is not acceptable. Health care is a defining and highly valued characteristic of our nation that must be addressed as a priority—not only during an election campaign, but throughout the time in office for whichever party is leading our federal government.

The CFPC will continue to advocate for the best possible health and health care for all Canadians, with a personal family physician for each person contributing considerably toward achievement of that goal.