The Chapters tell the story

Cal Gutkin

The whole is more than the sum of its parts.
Aristotle

Since its founding in 1954, the CFPC has recognized the Chapters as essential parts of our organization. Using the powers granted by our charter and bylaws, the College’s original Board of Directors established Chapters in each of Canada’s 10 provinces; all of them remain an important part of the CFPC today.

The CFPC is legally a single entity comprising the national College and its 10 Chapters. Members of the College who practise in any Canadian province must also belong to their provincial Chapters. To meet their unique jurisdictional needs, Chapters must be governed by their own boards, which are responsible for their bylaws, policies, and activities. If there are any substantive differences between the bylaws of a Chapter and the CFPC, the national College’s bylaws take precedence. Each Chapter also elects members to serve on the national Board of Directors to ensure the essential links between the Chapter and the College as a whole. The national board develops and approves core policies and positions that then apply across the country and are implemented through the combined efforts of the national College and its Chapters.

Current College membership is just above 27 000—40% of these members are in Ontario; 15% reside in BC; Alberta and Quebec each account for 12%; Manitoba and Saskatchewan are home to 4% each; Newfoundland and Labrador, Nova Scotia, and New Brunswick represent 2.5% each; PEI is home to 0.5%; and the balance reside in the territories or out of the country. With such disparity in numbers, it is easy to see how some Chapters might not have the resources to carry out all the activities achieved by their peers in other parts of Canada. Recent College efforts, led by the Chapter presidents, executive directors, and administrators have focused on establishing equity of opportunity for all Chapters to achieve optimal effectiveness.

As part of this process, the working group developed a list of core activities each Chapter should be expected to include as part of its mandate (eg, accrediting and delivering continuing education programs, holding an annual provincial scientific assembly, and advocating with provincial governments and sister organizations). Gaps between the expected and actual current activities are now being identified, along with strategies to provide the resources needed to help eliminate the gaps. The group also identified activities for which Chapter support is essential but for which the national College plays the lead role—eg, curriculum development and accreditation of family medicine residency programs; establishing continuing medical education and continuing professional development standards for family physicians across Canada; delivery of the national Certification Examination in Family Medicine and the awarding of Certification, Fellowship, and other special designations; coordinating the activities of family medicine teachers, researchers, residents, and students from across Canada; publishing Canadian Family Physician; presenting the annual Family Medicine Forum; developing national policies and advocating with the federal government about practice and health care issues that are priorities for members and their patients, regardless of where they live.

Funding to support the Chapters comes from their annual membership fees plus a yearly transfer from the national College. The latter has been increasing each year and is shared by the Chapters according to a formula determined by their presidents, with the smaller, less-well-resourced Chapters receiving greater amounts. This national College support is essential, as each Chapter must have adequate resources to be effective and credible. The members of each Chapter must be recognized for their participation on Chapter boards and committees and supported to develop the leadership skills required to do this effectively; every Chapter needs skilled staff, including an administrator to manage business issues and an executive director capable of developing and reviewing health care policies and, along with the Chapter’s elected leaders, acting as a Chapter spokesperson during interactions with governments, peer associations, and media.

With the political winds in Canada blowing toward decentralized decision making and authority in health care, there is a growing need for organizations like ours to have stronger provincial and territorial leadership than ever before. To be effective, Chapters must work together and support one another, and the national College must ensure that every Chapter has the resources it needs. To be successful throughout Canada, the national board’s policies and programs must be communicated and delivered cohesively by our national College and also by a strong and respected voice in each province—one that also delivers key messages related to policies and programs unique to that jurisdiction. That voice belongs to our Chapters.

Centuries later Aristotle’s words still ring true. The CFPC and its 10 Chapters must not be or be seen to be 11 separate or loosely linked entities. We are one—and to be effective we must function as a single unified organization whose whole is more than the sum of its parts.