“Just a GP” is a telling statement that reflects a mindset of inferiority, being second best, and being not that valuable. You do small stuff, write prescriptions, look at sore throats, and refer people to specialists. Who would choose this as a career? Especially when you also have to run a business, something you are clueless about, having spent all your time learning the language of medicine.
By the way, you also have to:
- Be available 24/7/365.
- Manage every patient issue that comes through your door, which includes their examinations, tests, investigations, and procedures, including surgeries, referrals, results, charting, and paperwork.
- In many places, work in your emergency room.
- Visit and care for your inpatients in hospital.
- Help deliver your patients’ babies.
- Anesthetize patients for your surgeon.
- Care for your patients in long-term care institutions.
- Make home visits for complex health care.
- Manage your dying patients in palliative care.
- Work in opioid agonist clinics.
- Work in doctor-in-school clinics.
- Work at a Foundry centre (if you have one).
- Provide medical assistance in dying services.
- Provide Diabetes Day Program expertise.
- Provide chemotherapy services.
- Offer group cognitive-behavioral therapy mental health services.
- Offer input to divisions of family practice and medical staff hospital associations.
- Contribute to primary care network development in your community.
- Keep up with your CME to meet your credits and stay up to date on rapidly changing medical knowledge.
- Provide multiple other niche services that fill the needs of the communities, large and small, in which we provide the bedrock of our health care system.
In addition, could you also please increase your patient attachment numbers, because we don’t have enough family practitioners to meet the needs of our communities?
You are rewarded with a fee-for-service system that encourages a high-volume practice, so spend as little time as possible with each patient.
We are discouraged, exhausted, and looking for alternatives in this increasingly stifling environment.
Do we, as family doctors, and do our society and our health care system truly recognize and value the critical role we play and have played for generations in this system?
As with everything, we must value ourselves first as creating the bedrock of our health care system with the incredible and creative roles we play in this system.
We are not just GPs. We are specialists in longitudinal comprehensive care. We need to value this indispensable role in our health care system while we also accommodate the other evolving and more specific family physician roles we perform.
Until we believe this, we will allow inequity to continue. Our education system, our health care system, and our society will define us as “just GPs,” and our medical students, residents, and practising family physicians will keep voting with their feet by choosing or changing directions to something more encouraging and rewarding.
We are in a time of transition in which physicians are seeking a healthier balance in their lives between satisfaction from their work and whatever creative pursuits and relationships bring them joy in the rest of their lives.
If we want to—and we must—increase the work-satisfaction part of that equation, let our voices be heard in valuing our offerings as family physicians, let us embrace the multiple and specific roles we fulfill, and let us reward the essential family physician role of a longitudinal comprehensive community primary-care (and sometimes secondary- and tertiary-care) provider. We are not replaceable, and we provide incredible value for money.
If we do this, the foot-voting will turn back in the direction of family practice, particularly longitudinal comprehensive family practice. If we further increase the satisfaction level of family physicians with business support, with a funding system that rewards comprehensive care while maintaining physician independence, with our primary care networks’ efforts of team-based care again, and with a funding and communication system that promotes this teamwork, our chronic problems of access and attachment will naturally start to resolve themselves.
I believe that at this point in time our government understands these issues and is open to addressing our critical needs in family medicine. As our General Practice Services Committee grapples with this and as we negotiate our Physician Master Agreement, please lend your support to the voice of family doctors and fix this crisis in health care that is eroding its foundation.
Let us make family practice an irresistible choice and confirm that we value ourselves and the essential role we play in a system that could not function without us.
We may just start to find real joy again in the amazing work we do.
—Rob Lehman, MD, CCFP, MClSc, FCFP(LM)
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