Practice management

When I completed my family medicine residency in 2001, I felt well prepared to care for patients, mentor students, and confer with colleagues. I initially performed a locum in a rural community and had the full scope of practice options in front of me. When it came to navigating other aspects of practice, however, such as financial matters and work-life balance, I was not as comfortably equipped.

During the next year I joined a well-established teaching practice in Edmonton, Alta, where I had completed my residency training. I had excellent mentors, was familiar with the practice, and did not face the even greater burden of setting up my own clinic. But because practice management challenges like these are often overwhelming for new doctors, during the past few decades residency training programs and the CFPC have improved how we support residents and physicians who are new to practice.

This summer, the CFPC launched the Practice Management (PM) Prep tool as a new resource for them.

The hunger for guidance in this area had consistently been raised in the CFPC’s First Five Years in Family Practice (FFYFP) Committee’s needs assessment surveys in 2010, 2013, and 2016. In fact, in 2016 more than 90% of those surveyed said they did not feel prepared for the business side of family practice (CFPC, unpublished data, 2016).

In response, the CFPC established its Practice Management Working Group in 2017 to develop an approach to support residents’ learning in this area based on competencies included in the leader role of the CanMEDS–Family Medicine framework.¹

The working group consulted internal stakeholders, such as the FFYFP Committee, the Section of Residents, the Section of Teachers, and the CFPC’s Chapters. It also consulted family medicine program directors and external organizations, such as the Canadian Medical Association, the Canadian Medical Protective Association, Resident Doctors of Canada, and the Royal College of Physicians and Surgeons of Canada.

Given the response that adding more time to the family medicine residency curriculum to teach practice management was not feasible, the working group decided to create a resource that would facilitate discussions about these issues between learners and their supervisors. The learners receive quarterly e-mails prompting them to refer to the PM Prep tool and complete an online reflection exercise in 1 of 6 areas of practice management:

• career management and work-life balance,

• financial management,

• lifelong learning,

• medicolegal issues,

• practice opportunities and options, and

• starting a medical practice.

Learners start by assessing their knowledge and identifying which topic they want to prioritize. They then complete a learning plan and are directed to a list of resources curated for that subject. Once they complete the exercise, they are encouraged to review their reflections with a preceptor, mentor, or group of residents with a family physician facilitator to deepen their learning. As a final step, the activity can be entered in Mainpro+^® for continuing professional development credits.

The PM Prep tool is now available through the FFYFP website.² The goal of hosting it on this site is to encourage its use among early-career family physicians. In the first phase of its launch the tool was promoted among second-year family medicine residents who were completing their training this summer. The CFPC will expand the promotion of PM Prep to all incoming first-year and ongoing second-year residents later this fall.

A key element that made PM Prep possible was collaboration among the external groups the CFPC consulted. In particular, the Canadian Medical Association, the Canadian Medical Protective Association, and the Royal College have generously shared numerous resources with us for inclusion in PM Prep, and we appreciate their support.

As we look to advance this initiative, I hope all preceptors and family medicine teachers will explore PM Prep themselves and encourage their trainees and colleagues to learn more about and from this resource.

The CFPC is proud to have developed PM Prep to address an identified need and ease the pressures that residents and new-in-practice family physicians experience as they launch their careers. I hope you find it helpful.

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