Changing face of family medicine

Protect the underlying theme of the comprehensive FP

I am well aware of the subspecialties in our College and the good they do in helping our patients. In addition, I know that the day of the all-inclusive FP doing hospital care, obstetrics, and pediatrics along with an office practice has faded. But we must continue to train our family medicine residents to look after the “bread and butter” medical and psychosocial conditions that we endeavour to help our patients with every day. With no disrespect to our fellow specialists, some have become so subspecialized that they only look after knees or ears. This is not the way I would like us to venture.

Promote family medicine as a career choice

We must continue to promote our specialty of family medicine with passion through teaching of and encounters with medical students, residents, and colleagues. The exposure to these groups through teaching is important to this concept and cannot be overemphasized.

Improve the balance in our lives

We must accept the fact that our younger colleagues appear to have a better balance between their personal lives and professional lives than we ever did. They are sharing family medicine practices, and both “father FPs” and “mother FPs” are taking time off to be with their newborns. We should embrace this balance and refrain from using the classic line “I remember when I was ....” We should learn from their example.

Support one another

We should all have our own FPs that we can rely on for our health needs. This support should start at the medical student level. As well, we should try and help one another when our health or that of our family members fails. We should also assist our colleagues who need a break or time off because they are afraid of burnout. It might involve a little extra work or call time but it will be appreciated and usually reciprocated when you need the same courtesy. We should at least treat one another as well as we treat our patients—have compassion for one another, always.

Advocate for patients

We must continue to advocate for our patients, especially in these times of turmoil and disjointedness in our health care system. This is one of the most important roles we play for our patients.

Participate in continuing professional development

We should continue to learn and strive to be the best FPs possible. The manner in which individual FPs decide to accomplish this task should be up to them, as I still believe each of us understands how we learn best. This will prevent stagnation and prevent the physician’s knowledge from becoming outdated, allowing him or her to give the most up-to-date care to his or her patients.

Honour traditions

We should remember to learn from our past and from traditions. Not all that is old is wrong. For example, the tradition of the housecall should not be abandoned, as it serves a purpose in certain situations. This is despite the fact that many physicians might believe this is outdated and unnecessary. I disagree, as housecalls might be the only way certain patients can see FPs. This promotes continuity of care. As well, the tradition of a housecall by the FP supports and comforts the patient. It accomplishes something sacred to our role as a physician.

The above is my vision for what I believe is important for FPs and family medicine. The face of family medicine might be changing in the 21st century. My vision for the new face continues to include the 4 principles of family medicine and is consistent with the 3 C’s in the Triple C Competency-based Curriculum, but I believe it goes beyond it. I believe the above statements are important to reflect upon to help guide us forward. This will allow us to continue the strong tradition of family medicine in Canada that Dr Ian McWhinney and others have envisioned.