Ed. note: This story is being republished with changed dates as a global Microsoft Azure outage shifted the Oct. 29 Annual Meeting of Members (AMM) to Nov. 10. For those unable to attend the AMM, proxy appointment has been reopened until Nov. 7 at 12:00 p.m. (ET).
The coming Annual Meeting of Members (AMM) of the College of Family Physicians of Canada (CFPC) Nov. 10 is not just another date in the calendar. It is a moment of choice. A moment to speak up. A moment in which showing up – whether in person, online or by proxy – means shaping the very foundation of what it means to be a family doctor in Canada.
This is not alarmism. The risks are real, and they are pressing. Yet, the opportunity to push back, to rebuild confidence and to reinvest in the value of family medicine has never been more tangible.
Family medicine in Canada officially began with the founding of the College of General Practice of Canada (now the College of Family Physicians of Canada, CFPC) in 1954, a key effort driven by W. Victor Johnston’s leadership in establishing national recognition for general practice. The discipline was further defined as a specialty in the 1960s and 1970s with the introduction of standardized medical school-based residency training and the CFPC’s certification process, a critical step for physicians seeking hospital privileges and professional recognition. Key principles of this discipline include the ability to respond to evolving health needs, adapt to changing circumstances and mobilize resources for patients. Without our certification, we actually are no longer family medicine specialists.
But, as I’ve written before, some voices in health-care circles have suggested radical changes, including:
- Shrinking some training to one year.
- Handing off core family physician responsibilities to other providers.
- Diluting standards in the name of “efficiency.”
- Dismantling the principle that family medicine should be self-regulated at all.
These aren’t just passing ideas. They reflect a broader trend and underscore the risk of the CFPC being consumed by another national medical organization or having no college at all.
If family physicians don’t defend the standards and the integrity of our profession, governments or other medical bodies will step in. And history shows us that when other organizations take the reins, family medicine is rarely their priority.
We cannot be managed by speciality groups because our generalized approach to patient care combines the power of relationships, longitudinal care, community, cultural and psychological factors. We cannot be replaced by Nurse Practitioners or Pharmacists because their scope and training are different from ours. And we cannot create a minimum standard for those trained in other jurisdictions. This doesn’t mean we cannot work in a properly constituted team.
Do we want bureaucrats or other providers outside our discipline deciding how we train, where we work and what our scope should be? Or do we believe in family medicine enough to defend our right to set the bar ourselves?
We already have the tools to protect and grow family medicine – if we choose to use them.
We already have the tools to protect and grow family medicine – if we choose to use them.
The CFPC is not just an administrative body; it’s the professional home of Canadian family medicine. It sets residency standards (the Red Book), accredits programs, runs exams, publishes research, supports advocacy and sustains professional development. It’s leaner than any other Canadian medical organization, with staff and budgets already cut to the proverbial bone.
And yet, even amid cuts, the CFPC has continued to:
- Subsidize exam fees for residents by 25 per cent (keeping $1,000 in residents’ pockets).
- Offer a 30 per cent reduced fee option for members on parental leave or working part-time.
- Uphold the only peer-reviewed family medicine journal in Canada.
The CFPC is far from a bloated bureaucracy. It is the infrastructure that keeps family medicine respected, regulated and viable. I invite you to look at its budget over the last many years.
And now we need to ensure stable funding for the CFPC and all its provincial and territorial chapters.
So, here’s the tension:
- Do we tighten the belt further, risk losing key member benefits, and leave space for others to take over regulation?
- Or do we take ownership, invest in our professional home, and secure the future of family medicine?
Reasonable people will disagree on how much the CFPC should spend, where to cut or how to raise revenue. That’s a healthy debate. But disengagement – shrugging our shoulders while others decide for us – is not an option.
Attending the AMM or assigning your proxy is not about rubber-stamping decisions. It’s about showing up to debate, to question, to push for the best possible future. It’s about saying that family medicine matters enough for me to take one hour – just one hour – to participate. Or fill out your proxy in advance.
The AMM is our chance to make that choice. It is our chance to ensure that family medicine remains a profession defined by family physicians – for patients, for learners and for future generations.
Will you be part of the debate?
Will you defend the profession you’ve built your life around?
One and a half hours. One proxy form. One collective voice. That’s all it takes.
Because if not us, then who?
Assigning your proxy and voting takes less than 1 minute. The unique control number is in the email called “CFPC’s AMM participation details”.
A reminder that the biggest danger here is the removal of member ratification of fee increases in perpetuity, up to inflation every year. This takes away your ability as members to hold the organization to account. Don’t lose your democratic voice.
Even if you feel they deserve a fee increase, should they get one unchecked every year from now on without your say? It is too late to adjust the language to this motion this year. The only way forward is to vote this down and include language next time maintaining your voice as the final stopgap.
I am also highly disappointed that the organization threatened those on maternity and paternity leaves with targeted emails that the member discount may be eliminated if they don’t vote the way the organization wants. This is an affront to gender equity and directly affects members’ finances during times of reduced or eliminated income. For an organization catering to family medicine, this is an attack on members with new families.
TL;DR: Vote REJECT to motion 3 on fee increases (referred to in Orwellian fashion as “fee stabilization”) either at the AMM or by proxy.
Dr. Stephen,
I have difficulty with the logic of your conjectures. There has been no increases in membership fees for many years but inflation is ongoing. Your posit suggests that organizations only experience inflation once in a while and the membership must police the validity of cost of living increases. You are entitled to your opinion, however in my world inflation happens consistently. I guess expecting more services, more advocacy, and better outcomes by spending less and less makes sense in the world of political bafflegab like paying doctors for health care, hospital services, environmental protections, etc. Thank you for your opinion.
The member voice must never be made silent. Leadership learned this lesson quite painfully when the mandatory three year residency was being pushed and touted as a “done deal” by the Board. As you may recall, that motion was defeated at 92% against. I was proud to help lead that revolt.
Members must always have the final say in how the organization is performing. The organization should not be rewarded with forever increases to infinity when as you say physicians themselves cannot keep up thanks to government, and indeed continue to struggle and close practices. Members at the ground level have not seen much representation or benefit in the organization. The threat against those on maternity and paternity leave was also in extremely poor taste.
I would encourage leadership to look at other more logical solutions, such as reassessing the goals of the CFPC. Accreditation makes sense to continue. Advocacy can be branched off and subsumed by the CMA. These are difficult times for all organizations and changes may be needed. Clearly the status quo has failed.
I am not the only voice. I carry the responsibility of hundreds of proxy votes who all feel the same. The members’ voices will not be silenced.
This all sounds like a great idea. What’s missing for me is any evidence that the CFPC has done anything at all to advance these goals. Our profession remains under fire, scope creep is proceeding unimpeded, and graduates are opting out of the specialty in groves. Can you point me to proof of tangible progress that the CFPC has made on these advocacy fronts? Because that would be worth my money.
DR. Robinson, here is the link (below) to show tangible progress.
https://www.cfpc.ca/en/member-services/about-membership/membership-faqs
The bigger issue is that an organization that does not stabilize its finances then it becomes HARDER to advocate, to fight for self- regulation, and manage attacks like Bill 2 in Quebec. Thank you for seeing the bigger picture.
Excellent article by Dr. Alykhan Abdulla! It’s very important to be positive about this. Too much negativity has damaged the image of family medicine and reputation of family physicians. The good about what we do as family physicians should be louder than the bad about what is done to us.