Protecting terms: an update

Francine Lemire

Dear Colleagues,

Like many of you, the CFPC is concerned by some co-opting terms such as family practice, family medicine, or family physician. This is an appropriation by those who do not have the medical education and training possessed by family physicians and recognized by licensing authorities that might confuse and mislead the public. As troubling as this is, we need to remember that reasons are multifactorial and might include issues of access to care.

Last April, 95% of more than 3000 respondents to a CFPC poll indicated protection of terms is an issue, as it is critical to family physicians’ sense of professional identity; 92% of respondents thought that the CFPC should address this.

What have we done since? The Federation of Medical Regulatory Authorities of Canada shared the results of a scan of its members to determine the status of various provincial legislation. We corresponded with each regulatory authority to better understand the nuances. In summary, terms such as family doctor, FP, or general practitioner and GP are best protected in Quebec, Ontario, Manitoba, and Alberta. In British Columbia and the Northwest Territories, the terms doctor or physician can be used, but a naturopath must use the terms naturopath, naturopathic, or naturopathic medicine in their title.

In the past 18 months, 3 incidents have garnered attention.

In a legal judgment in New Brunswick, where naturopathy is unregulated, the privilege for a naturopath to describe themselves as a doctor or a physician was removed.
In Ontario, the College of Physicians and Surgeons of Ontario, the CFPC, and the Ontario College of Family Physicians challenged a nurse practitioner group practice for inappropriately using family medicine terms to describe their services.
In a ruling in British Columbia, a judge struck down a request by the College of Midwives of British Columbia to forbid the use of the term midwife being applied to describe the role of “death midwives.” The college’s argument was that the term, in this context, is very different than the role we traditionally associate with midwifery.

Because terms are regulated at the provincial and territorial levels, we have been establishing alliances to better protect the terminology reserved for our members. As we continue to pursue this complex issue, we have been clear that the CFPC is concerned that some nonmedical professionals might be misleading the public by using terms such as family practice, family medicine, and family physician to describe themselves and their work.

Individuals who use these terms but who are not educated or trained as family physicians are misrepresenting the services they provide and confusing the public. The CFPC is strongly opposed to this misrepresentation.

Patients and communities must be able to count on high-quality, evidence-based care from Certified family physicians in collaboration with their interprofessional teams.

The CCFP special designation is a symbol of excellence for family physicians who have achieved and maintain Certification in the CFPC. It reflects their commitment to lifelong learning and the principles of family medicine.

The CFPC continues to work with partners across Canada to maintain and strengthen protection for family medicine terminology to support family doctors and protect patients. Our full statement is available here: www.cfpc.ca/appropriate-use-of-family-medicine-terminology.¹

To quote our President, Dr Shirley Schipper,

Only family doctors can do family medicine, with invaluable contributions from their interprofessional teams including administrative staff, nurses and nurse practitioners, and others. As we respect the contribution of other providers in the Patient’s Medical Home, we expect other professionals to describe themselves accurately.

Family doctors will continue to demonstrate the scope of their work, not only by describing it but also through everyday actions. Here are some ways for you to highlight your expertise, experience, and dedication to family medicine.

Use your special designation MCFP, CCFP, or FCFP.
If you are aware of misrepresentation by a provider, inform your licensing authority.
Review with your family practice colleagues whether there is anything more that could be implemented to improve access in your family practice. Connect with your provincial medical association, as it needs to hear of your needs in order to better support you in improving access.

The CFPC is proud of the rigorous standards it sets for family medicine, and we stand behind our members as they care for patients across Canada.