Throughout the 1990s and the early 2000s, family medicine in Canada was facing a crisis. The federal government had reduced residency positions across the country, the remuneration system was flawed and the perception of the specialty itself was negative.
As a result, in 2003, the percentage of medical students going into family medicine hit an all-time low: 23%. In the ensuing years, the College of Family Physicians of Canada (CFPC) — as part of a team effort across all sectors — was able to curb the trend by implementing family medicine interest groups in every Canadian medical school, working to improve how family doctors get paid, and establishing family medicine as a recognized medical specialty.1
By 2020, 45.6% of medical students went into family medicine. While the specialty’s reputation has been repaired, you may still have a lot of questions about a career in family medicine.
How will you know if family medicine is right for you? Here’s a primer that may help you make that decision.
What do family physicians do?
The CFPC describes it like this: “Working together, family physicians provide a system of front-line health care that is accessible, high-quality, comprehensive and continuous.”
Family physicians are the first point of contact for their patients’ health concerns — and those patients are a variety of ages and have different social backgrounds and health conditions. That makes the day-to-day demands on family physicians incredibly diverse. They not only treat the immediate needs of their patients, but must also help them navigate the wider healthcare system, from coordinating with other specialists to overseeing hospital care, while prioritizing and ensuring access to these services.
Family medicine is about a lot more than office-based practice: it includes home, hospital and long-term care, along with opportunities to be engaged in leadership, scholarship and advocacy.
Why do people choose family medicine?
The reasons for choosing family medicine are diverse and personal. Some students are excited by the sheer scope of everything they’ll need to learn and do. As a family physician, you’ll be assessing and treating newborns and elderly people alike, and to do that your range of knowledge and skills will have to be incredibly vast.
Other students might have an entrepreneurial spirit and like the idea of building and refining a practice, or working as part of a team in a Patient’s Medical Home — the CFPC’s model of delivering comprehensive and coordinated care for patients.
Many students are attracted to the versatility of a career that can grow and adapt with them. You might want to build a more stable career around your family and community — family medicine supports work-life integration and can be tailored to your stage of life and stage of practice. Even the residency period can be friendlier to manage than that of other specialties due to its shorter length (two years).
You may also be attracted to the idea of building long-term relationships and caring for patients over a significant part of their lifespan. For anyone who wants to work in a rural setting, family medicine is often the clearest path. This choice also opens up more options to work locums.
Why do some people avoid family medicine?
There are a number of reasons that family medicine might not be right for you. One of the questions students often ask is about the compensation. Family medicine pays a little less than most other specialties do. Salaries do vary by province, however, and family medicine is certainly not the lowest paid medical specialty you can choose.
The time constraints that many family physicians must face — trying to see as many as five patients per hour for about 10 minutes at a time — can frighten a lot of med students away. As well, the administrative requirements associated with running a family practice can be challenging (though the cost of running a practice is something that many physicians, not just family doctors, have to deal with).
What’s special about family medicine?
Family physicians are specialists at being generalists. This means that they have a lot to offer beyond patient care; they have a broad set of skills and are highly adaptable. Unlike some other specialties that can be more narrowly focused, family medicine encompasses a whole spectrum of care including biological, clinical and behavioural sciences.
In the end, all family physicians — regardless of the specific nature of their practice — embody a humanist approach that helps to uphold and improve the compassion, responsiveness, integrity and quality of the healthcare system.
How can I learn more?
The CFPC hosts a popular committee for family doctors who are in their first five years of practice. It also provides numerous resources about learning how to build a practice, the billing process and all the other new requirements that early career family physicians face. It also hosts a Facebook page with peer support to share questions and learn from each other’s experiences.
You can also check out the links below to learn more:
Family Medicine Interest Groups: Strengthening the future of family medicine
1 Family Medicine in Canada: Vision for the Future, November 2004