Advice to a Student about Family Medicine

“This too shall pass”- Persian proverb

The Ontario Government’s unilateral cuts to physician services unfairly targets young family doctors, residents training in family medicine and medical students who hope to make a career in family medicine. By severely restricting entry into non-fee-for-service practice models (capitation) the government is also denying young family doctors, and their patients, the many benefits of practicing in a Family Health Team.

All of these physicians have been trained in multidisciplinary teams and are used to working side by side with mental health counsellors, primary care nurses, nurse practitioners, diabetic educators, physician assistants and other primary care team members. Now if they wish to practice in a community outside those designated by the government, they will be forced to practice in fee-for-service, without any other team members. Hard for them, harder for their patients.

I have previously written about this and for a more comprehensive look at the issue refer to a great piece by Globe and Mail reporter @kellygrant1 at http://t.co/Ux35fKhTA3

Dr. Ved Tandan, President of the Ontario Medical Association, has been travelling across the province explaining to doctors the implications of the government cuts and what plans we have to minimize harm to our patients and while protecting the interests of our members. He has been relentless. He’s good at it too.

He has asked Dr. Mike Toth, President-elect and I to help out and we have begun engaging medical students and family medicine residents in our discussions. I try to be open and honest but it can be pretty bleak from our trainees point of view when they discover just how arbitrary and policy deprived the Government can be.

I have been asked by students what advice I can give for someone in their position in terms of career choice. These are people who want to become family doctors but are concerned about their futures.

I would advise anyone thinking about a career in medicine to take the long term view. They will be in practice for 30 or 40 years and they should not be distracted by short term turmoil in the medical profession.

I started my practice in 1986. At that time the OMA was embroiled in a significant dispute with the Peterson Government that resulted in an unsuccessful ‘strike’. What an initiation into practice!

I lived through the caps, claw-backs and Rae Days of the early 1990s. And I remember wondering if family medicine would even survive as a discipline in the early 2000s

I’ve also lived through the exciting and dynamic days of primary care reform where doctors, nurses, the OMA and Government worked together to build a better primary care system that put the needs of patients first. We saved family medicine and enhanced primary care

Despite all the turmoil and problems I love my job. I think it’s the best job in the world. I have multi-generational families in my practice. Most people are fun and they are a joy to listen to. Their problems are very real. Some are small problems and some are enormous. But they accept whatever help I can offer with gratitude and respect. It’s the relationships I have with my patients that makes this job so rewarding.

I do have the luxury of working in a team and that team is another source of satisfaction. I never feel like I am isolated or alone with a problem. There are other people with whom I can share my burden.

I wake up every day, happy with my practice and my career.

This government has forgotten a lot of things. They have forgotten that we need to do what is right for patients. They have forgotten what it is like to lose a generation of family doctors. They have forgotten that their decisions need to be based in good sound policy.

They will remember, of that I am confident. And if they don’t remember, their successors will. We will go back to team based care and we will not ask our youngest doctors to pay for a temporary fiscal problem.

The Government will remember the difference between cost and value

That’ why young doctors and medical students should think long term and pursue family medicine.

Scott Douglas Wooder, MD

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