Rural generalists and quality of care

In the September 2024 issue of Canadian Family Physician, Correia et al look at family physicians who have Certificates of Added Competence (CACs) in care of the elderly.¹ Despite mentioning the roles comprehensive family physicians play in looking after the elderly, they say those who have CACs in care of the elderly “had evidence of additional scope to better support older adults.”¹

Does the evidence really support this? Is there evidence that full-scope rural generalists provide worse care to their patients? The best physicians are often able to see their patients through multiple different lenses, and caring for generations of a family provides a unique and valuable lens. While it is difficult to count the number of rural generalists, there are certainly more of us than there are people with CACs in northwestern Ontario.

As we continue to try to encourage learners to have a broad scope of care, let us celebrate and enumerate those who do just that. And let us look to the evidence before making assumptions about the ability to support our patients.

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