Value of family physicians

Facing the challenges

How does the College work to realize these goals? The College is not a negotiating body and thus does not directly bargain for payments or supports for family physicians. Our efforts are based on effective advocacy grounded in evidence and advanced through highly functional relationships with decision makers, other health care providers, and patients.

Currently, family physicians in many parts of the country are feeling beleaguered. During my year as President, meeting colleagues from every province and territory, I witnessed this first-hand. Family doctors in some communities are facing closures or transformations of health care facilities that will considerably limit their ability to provide the broad scope of care required for obstetric, emergency, or hospitalized patients. These changes constrain opportunities to pass important skills and knowledge on to the students and residents who will become the next generation of family physicians. Provincial governments might recognize the importance of strengthening primary care, but with the imperative to control budgets, they might go about it in ways that are coercive or ineffectual.

The feeling that family physicians are undervalued is reinforced by statistics. The Canadian Institute for Health Information recently reported that family physicians receive the third-lowest average gross clinical payments.² The same report shows that the growth of alternate payment approaches, which often support the work of family physicians better than fee-for-service payments do, has leveled off. Statistics on burnout are the subject of debate, but there is little doubt that it is a real phenomenon and appears to be rising.^3,4

On the other hand, polls regularly place physicians among the most respected professionals.³ Given that most interactions that Canadians have with physicians are directly with family physicians, our role has an important influence on those findings. It is undeniable that the work of family physicians, while demanding, is deeply rewarding in its effects on the lives of those we serve.

Opportunities and supports

Supporting and advocating for family physicians is especially crucial in challenging times. The vision of the Patients’ Medical Home is helping to guide negotiations about payment approaches and infrastructure support between provincial and territorial medical associations and governments. The strong relationships between our national College and other national health care organizations, such as the Royal College of Physicians and Surgeons of Canada, the Canadian Nurses Association, and the Canadian Medical Association, are crucial to success in this realm. In a like vein, vibrant engagement between the CFPC and our provincial Chapters ensures coordination and complementary advocacy in each jurisdiction. Effective advocacy is grounded in evidence. The College’s role in championing research is essential to demonstrating the value of the patient care provided by family physicians.

We have the opportunity to learn and to borrow from sister organizations. The Canadian Medical Association and the American Academy of Family Physicians both focused their most recent annual meetings on inspiration and physician wellness. A superb resource on physician health and preventive approaches is available from the Quebec Physicians’ Health Program in French (www.pamq.org/fr) and English (www.pamq.org/en).

One of the great privileges for College Presidents is the opportunity to speak with students in the family medicine interest groups in medical schools across the country. The enthusiasm that these young people demonstrate in their aspiration to join our discipline is truly moving. I would like to share their passion with all the family doctors in Canada, to help inspire and sustain us.