W. Wayne Weston MD CCFP FCFP

William M. Glenn

“One of the driving forces of my entire academic career has been helping new graduates avoid what I had to go through.”

In April 1970, Dr Wayne Weston gave his first speech as a young doctor—Family Medicine: A New Specialty—to colleagues at his local hospital’s “clinical day.” And it certainly was a new specialty. Just 6 months earlier, Dr Weston had been one of the first dozen physicians to receive Certification from the College of Family Physicians of Canada.

He remembers being a bit nervous, but little else about the event. That’s not too surprising. In the intervening 44 years of medical practice and a respected teaching career, Dr Weston has given hundreds of presentations and workshops. But although the details of that first outing are now vague, he concedes that his presentation would be “a lot different today.”

“When I went to medical school in the 1960s, there was no special training to be a family doctor. There was no residency program for it,” Dr Weston recalls. “We were taught to be paternalistic, to take charge, and to provide whatever treatment we thought best. We were not taught to explore what the patient wanted or expected.”

After graduation, Dr Weston says he was “incredibly fortunate” to join a 5-doctor practice in the small village of Tavistock, Ont, halfway between Woodstock and Stratford. There he learned the basics of family medicine from the senior doctors as they tended a large roster of patients drawn from the neighbouring farms and small towns. One of those senior physicians, Dr Bruce Halliday, also served as Member of Parliament for the riding of Oxford for nearly 20 years.

“We need to do our best to listen to whatever the patient brings us”

“He taught me that politics wasn’t much different from medicine,” says Dr Weston. “You spend your day sitting in an office and people came to see you with their problems. You hear them out. And then you help them find the resources they need.”

Today‘s patients can be challenging. They have access to more information, a propensity to self-diagnose, and concerns about the effectiveness of different treatment options. They come with opinions, expectations, and questions. So doctors have to be different too.

“We need to do our best to listen to whatever the patient brings us in order to understand their needs, their values, and their goals in life,” says Dr Weston. “It doesn’t mean we do whatever they want. But neither do we take over. Rather, we give them the benefit of our expertise and together work out a course of treatment that reduces the impact of the disease on what really matters to the patient.”

Dr Weston still remembers feeling lost—“all at sea” he calls it—during his first years of family practice. “One of the driving forces of my entire academic career has been helping new graduates avoid what I had to go through,” he laughs.

A doctor has to know how to tell patients bad news, how to sift through their treatment preferences near the end of life, and how to disclose an error or a “close call” rather than trying to cover it up. Most of all, medical students and residents “need to realize the complexity of communication,” says Dr Weston, “and—if they can develop those skills—what a big difference it will have on the health and outlook of their patients.”

PHOTOS: Dr Weston enjoying the outdoors with his grandchildren, Nathan and Claire.

Footnotes

Dr Weston is a retired family physician living in London, Ont, and Professor Emeritus in the Department of Family Medicine at Western University in London.
Photos: Laura Bombier, Toronto, Ont