I love family medicine but I'm worried and frustrated

I have been a family doctor for almost 30 years. I share my joy of longitudinal comprehensive family medicine with my patients, my medical students and residents, staff and community. But I am worried. I am worried about medical students not choosing family medicine. I am worried about corporations hiring doctors to fill prescriptions for every medical problem without fixing anything. I am worried about my colleagues burning out, retiring early, leaving family medicine, working a narrow scope, and becoming service providers instead of longitudinal comprehensive family physicians. I have worked in medical education for over 20 years training medical students, residents, and internationally trained medical doctors to (re)join the Canadian healthcare system which has been joyful. But I am frustrated. Policy makers expect family doctors to calm patients down when there are long waits for services and that is frustrating. Governments expect family doctors to fix all the problems: like to see patients in the middle of pandemic without PPE (personal protective equipment) or provide COVID-19 vaccinations with rapidly changing policies which is frustrating. Economists want family doctors to treat complex multi morbidity patients as a treadmill with patient quotas per week which is frustrating (and demoralizing). I have been in medical politics for 10 years now trying to work with policy makers, academics, and a plethora of well minded experts who want to make things better for all Canadians. Overall I feel we are making slow progress. But now I feel threatened. I feel threatened that those that can make a difference would rather offer platitudes about family doctors as heroes. I feel threatened that those who espouse investment in a family doctor for every Canadian actually have no commitment to follow through. I feel threatened that all of our hard work and dedication to comprehensive longitudinal evidence based and quintuple aim family medicine will be for naught when we have a smart phone app that will offer prescriptions and loyalty points. I feel that family medicine is not respected. I feel decades of underfunding in family medicine will destroy socialized patient-centred health care. I feel that recommending family medicine as a “calling” to my community, my students, and my daughter, is a deception. I love being a family doctor but I feel disrespected, in an existential crisis and deceived. Dr. Alykhan Abdulla is a family physician and the medical director for the Kingsway Health Centre in Manotick, Ont.

I love family medicine but I'm worried and frustrated

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