President's Message

Garey Mazowita, MD, CCFP, FCFP

Traveling across the country as your President - a fascinating experience!

I cannot recall ever experiencing such a wide range and mix of emotions; I've witnessed excitement and concern, and everything between. 

The students and residents I meet across Canada continue to impress me with their commitment to comprehensive care. (My apologies here to the Family Medicine Interest Group and FM Residents I met at the University of Calgary. I mistakenly referred to the school as the University of Alberta in an earlier President's message.)  I, like others, worry about the tendency of some graduates to immediately focus theirpractice upon leaving residency. Happily, there appears to be a growing appreciation of the value of consolidating one's comprehensive skills prior to consideration of a focused practice; and, for those completing an R3 year, the value of grounding focus within comprehensive practice. This being said, those of us in the workforce fully appreciate the increasing complexity and demands of traditional family practice, which is one of the factors that can encourage early practice focus. These dynamics now appear to be fueling an interest in examining residency length. Perhaps a three-year residency will solidify comprehensive skills and confidence while still allowing for focused interests?  Arguably, the "value proposition" of family medicine is grounded in comprehensive care, and augmented by focused practice that is built upon a comprehensive care foundation.

In other areas of membership there are serious concerns. For instance, Quebec is facing challenges arising from Bill 20. This legislation stands to make patient volume and panel size the determinants of "value," at the potential expense of teaching, research, and administrative activities. While clinical productivity is clearly important, "value" in family medicine cannot be defined solely by volumes if we are to have an academic component to our discipline.

Encouragingly, at McGill I met an incredibly supportive Dean, and a Department Head who impressively had one foot in health system change and the other in research and education. Quite inspiring!

In other areas, our members and Chapters are actively seeking practice solutions to the access issue, whether through practice redesign, networks, or more aligned reimbursement schemes. Some directions appear to be emerging; the question will be whether we can implement them quickly enough to avert imposed solutions arising outside our discipline. 

Finally, everyone I encounter is tuned into the need to demonstrate quality and accountability. To do so, we need to "own" these dimensions, and move on them quickly.

Garey Mazowita, MD, CCFP, FCFP
President, CFPC

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