The history of family medicine practice management

I read the President’s Message on practice management¹ by Dr Shirley Schipper with great interest. I applaud the important initiative on a neglected topic for family medicine (FM) residents as they prepare for FM practice.

However, someone reading this article might get the wrong impression, especially if they do not have previous knowledge about what has taken place for teaching practice management to FM residents in various Canadian FM programs. They might think it was not taught or it was not a priority before this initiative. This is not the case.

In December 2001, Dr Paul Humphries was Director of Postgraduate Education in the Department of Family Medicine residency program at the University of Alberta (UA) in Edmonton. Being a bit of a visionary, he saw the need for practice management to be taught to FM residents at UA. Knowing my passion for teaching medical students and FM residents about FM and practice management, he asked me to be Coordinator of Practice Management Education for the program. I continued this role until 2018 when the new initiative was started and my position was dissolved.

With the aid of great support staff and with the support of the faculty at UA, we successfully presented a 2-day seminar to the second-year FM residents and were available for consultation during the year if needed. This seminar was accomplished with the additional support of a family physician from the practice arm of the Canadian Medical Association, later called Joule.² We were careful to avoid any bias by my presence throughout the seminar. Each year until 2017, an updated family medicine FM practice management booklet was prepared and sent electronically to each of the UA FM residents. This included sample locum tenens contracts, guidelines on how to start and write a medicolegal letter, and a checklist of things to do before starting an FM practice. The generic form of this checklist was adapted with my permission in 2017 and is now part of a Joule practice management module in both English and French.

I know it was not the intent of Dr Schipper to underplay the role that other FM preceptors have played in teaching practice management before this new initiative. I know this as I have read about her own positive experiences, and she supported my attendance at the aforementioned seminars during her time as former Postgraduate Family Medicine Director at UA. My point is that those across Canada who have been quietly preparing FM residents for FM practice (like myself) should not be forgotten.

In addition to this initiative by the College of Family Physicians of Canada, please do not forget to let your FM residents, those in their first 5 years in practice, and all Canadian family physicians know about other important practice management resources. There are resources available on the Canadian Medical Association website.³ On this site, there are multiple modules, some similar to those in the initiative, and many more that will help in learning about practice management for FM residents in Canada.

Thank you for reading my comments. Once again, congratulations on such a fine initiative by the College of Family Physicians of Canada.

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