Welcome to all our new family physicians

In June, I had the immense privilege of speaking at graduation ceremonies at the Northern Ontario School of Medicine in Sudbury, and the Faculty of Medicine of Université Laval in Quebec, Que, and welcoming the new graduates into the family of family medicine.* I want to extend this welcome to all of our new family physicians. For those of you who had already completed studies in another country, it is the start of a second career after many years of effort and sacrifice. Congratulations! Allow me to share a few thoughts with all of you.

The profession of physician, and that of family physician in particular, is privileged. Throughout your career, you will have the opportunity to cultivate a number of your talents. A physician is both a scientist and a humanist. I hope that you will never lose the sense of curiosity that sustained you during your studies: curiosity about the infinite world of knowledge and curiosity about the people who are your patients. For—does it need repeating?—health is about people. The health professions are service professions. I’m not talking about vocations. But to divorce the notion of service from a physician’s work would do away with a fundamental dimension of this profession. In an article I find very inspiring, Donald Berwick suggests that we should always consider ourselves guests in our patients’ lives, rather than seeing them as our guests in our offices.¹

The essence of professionalism is this mix of technical competence and service orientation, inspired by a commitment to ethics and feeling of social responsibility.² In my opinion, this is the greatest challenge of a rewarding medical career: always respecting oneself as a person, without putting up barriers to protect ourselves from other people, patients, and colleagues. It took me a while to manage this myself. Oddly enough, it was my husband who helped me the most by making me realize that I often put up what he called “little fences.” Then, during the Balint meetings we used to organize for our residents, our facilitator gave us this piece of advice about the feeling of being overwhelmed that we often reported when faced with patients’ demands and our attempts to contain them: you have to let go of control to regain mastery. Do not put up “little fences.” I found this piece of advice, given years ago, again in the article by Donald Berwick that I cited earlier: “Take over control only rarely and with permission freely granted.”¹ Like Berwick, I believe that we waste a tremendous amount of energy trying to enforce all sorts of restrictive rules in our relations with our patients and our ways of working. While many physicians fear that patient-centred means that patients will be more demanding, Berwick suggests that patient-centredness will be experienced as a relief. Let go of control to regain mastery.

There is a lot of talk about the advent of a new professionalism that is both patient centred and founded on teamwork.² This new professionalism is liberating and allows us to not lose ourselves while remaining fully committed. There is still some way to go before many of the barriers to this new professionalism are broken down. To achieve this, we will need you, as it is a professionalism that corresponds with your values.

So, that is my advice for a fully satisfying career: nurture your curiosity, be team players, respect your patients’ intelligence and trust them, and always take care of yourselves and those close to you. By maintaining this balance, you will experience, on a daily basis, what I believe is the greatest privilege of being a physician—that of always going to bed in the evening knowing that you have helped someone, that you have made a difference in some way. This feeling contributes to the fundamental quest of all human beings—the search for meaning.

I welcome you to our fine profession and our College. We hope to see many of you at the CFPC graduation ceremony in Vancouver, BC, on November 9, 2013. In the meantime, make the most of the summer and enjoy your well-deserved success.

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