Money talk: a CFPC financial update

Regardless of when the use of money started, it’s certain that’s when people started worrying about it. They say money can’t buy happiness, but this is, of course, dependent on a person’s baseline wealth. For the wealthy, the continued pursuit of money has diminishing returns on happiness. For individuals of limited means, money does buy happiness in the form of basic comforts, needs, and security. In the case of non-proft organizations like the College of Family Physicians of Canada (CFPC), money sustains our capacity to set standards and provides opportunities to meet and enhance member needs.

The CFPC must provide standards for the self-regulating discipline of family medicine, or governments will find reasons to assert more control or simply take over our profession. We should never doubt or underestimate the reality of this risk. As for the value of membership, the defnition depends on whom you ask. For many members, it’s defined as advocacy leading to better pay for family physicians. For others it’s having research support; receiving continuing professional development (CPD) offerings; developing educational content; advocating for team-based care; promoting family medicine resident rights; supporting awards and member interest groups; and having a list almost as large as our imagination. As money becomes scarce, less and less can be offered to the value proposition of the CFPC.

Historically, the primary source of revenue for the CFPC has been member dues. Additional sources of revenue include commercial elements like the Self-Learning Program or Family Medicine Forum, sponsorship support from partners like Scotiabank and MD Financial Management, and investment returns. Essential offerings like exams are vital to the profession, but exams are high stakes by nature, and therefore expensive to run. Exam fees do not cover the full cost of testing and require some subsidization through member dues.

The CFPC’s last member fee increase was in 2017, despite an approximately 25% cumulative inflation increase in the time since. Over the past 8 years, small reductions in expenses and disruptions from the COVID-19 pandemic (eg, no in-person meetings or travel) minimized the potential effects of inflation. However, by March 2024 the CFPC had a budgeted $5.5 million deficit for the 2024-25 fiscal year, and was using reserves to support ongoing programs. In May 2024, the CFPC Board of Directors and staff set the ambitious task of working rapidly toward a balanced budget, without fee increases, and limiting the use of reserves. The projected 2024-25 shortfall was reduced and the deficit resolved. For 2025-26, we estimate a small surplus to cover planned one-time expenditures and limited reserve fund use to weather the considerable financial disruptions arising from the United States.

While we can celebrate the CFPC’s renewed financial stability for the next year or 2, good programs were cancelled, and great people lost their jobs. Reductions included 24 staff positions, moving to a primarily remote office, and dramatically reducing physical office space. We implemented cutbacks to the Foundation for Advancing Family Medicine, closed the Besrour Centre, trimmed from 12 to 10 editions of Canadian Family Physician, reduced in-person committee meetings, and cut library services.

Many members noticed these cuts and some voiced their concerns. We appreciate your feedback and apologize if service cuts have affected you. Unfortunately, a budget deficit of over 10%, and an uncertain financial future required action to ensure the stability of family medicine’s professional home. We are concerned that further cuts will challenge our capacity to maintain family medicine standards, advocate for members, provide CPD, subsidize exams, publish the only Canadian family medicine journal, and more.

This dilemma requires member engagement and support for fee stability through linking member fees to inflation. If the CFPC was previously wealthy, those days have passed. High inflation eroded the funds we have available. Membership dollars have been stretched and, to preserve the future of family medicine, we must stabilize the CFPC’s finances to maintain critical programs. The value proposition of family medicine is improved health care for Canadians and this requires a healthy professional home. The CFPC is not seeking to buy happiness, but linking our fees to cost-of-living increases offers security, and allows us to provide the basics for our members and the profession, now and into the future.

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