Tone deaf CFPC fails its members, embarrasses itself

Recently, in what seems to these old eyes to be an insulting, vindictive and offensive move, Canadian Family Physician, the “official journal of the College of Family Physicians of Canada (CFPC),” published a hit piece on family doctors that only serves to further demoralize and dishearten a beaten down profession. I cannot fathom the amount of, what at best could be described as political naïveté, and at worst a disconnected Ivory Tower mentality would be required to write such a venomous attack on those who actually pay money to keep their organization going. Seriously, what was the CFPC thinking when they okayed Dr. Roger Ladouceur’s editorial, titled “Family medicine is not a business”? (I refuse to link to it as I don’t want it to get any more hits.) Truly, it’s not really an editorial, rather a massive litany of complaints against family physicians, while sarcastically suggesting “surely, it’s just gossip!” What exactly are evil, rotten family doctors doing according to Dr. Ladouceur? He suggests the CFPC has “heard stories” about family doctors not seeing patients in person and wondering how they can assess complicated patients. He has “heard stories” about doctors only calling patients at more lucrative times and abandoning patients with high medical needs. He has “heard stories” about family doctors “charging excessive fees” for services not covered by health insurance. He ends off his purulent missive by blithely stating: “family practice is not a business.” Marie (“Let them eat cake”) Antoinette would have been proud of such a comment, dismissively heaped on the approximately 40,000 overworked family doctors in Canada. There’s a lot to unpack in Dr. Ladouceur’s diatribe. First and foremost is the fact that despite extolling the virtues of evidence-based medicine, the CFPC allowed an editorial to run that had, well, no evidence to back it up. The whole argument was based on “I have heard stories.” There are no numbers to back it up, no names of offending physicians, no statistics on how widespread these alleged problems are. Just gossip and innuendo based on what he has “heard.” If you want evidence, by the way, I can confirm that the OMA board was told that based on OHIP billing data over 98% of family doctors in Ontario continued to work after the pandemic was declared. It is true that they are using a mix of virtual and in-person visits, but given the need to social distance during these times, a mix is clearly the correct way to proceed. Furthermore, the banal statement that “family Medicine is not a business” is simply factually incorrect, and reveals a kind of ignorant, Ivory Tower mentality that shows a complete disconnect from the real world. Let me be clear about this, I consider myself one of the lucky ones. My family has food on the table. We have a roof over our head. There is no danger of my car being re-possessed. I’m fortunate compared to the average Canadian and am extremely grateful to be in that position. But while I genuinely enjoy seeing my patients (they’re a great bunch of people), I still have to pay my staff, order supplies, pay rent and utilities, ensure my computers are working properly, get payroll taxes paid, comply with labour legislation, etc. In short, while we all hate to think about this side of things, family medicine has been, and will continue to be, a business of some sort. That the CFPC would allow such an obtuse comment by Dr. Ladouceur to run, shows a wanton disregard and, dare I say it, contempt for the many day-to-day issues that its members face. Look, no physician likes seeing one of their organizations scold them (and certainly I will always push back when I see this kind of stuff happening), but I really have to wonder just how completely out of touch the CFPC must be to allow this type of berating in the middle of the biggest physician burnout crisis I have ever seen. Prior to the pandemic, 26% of physicians were clinically burnt out, 34% were suffering from a degree of depression and over 50% reported some symptoms of the burn out. Exactly what do you think has happened to those numbers after the pandemic? Especially with physicians recognizing that even though we seem to be coming out of the pandemic, there is an overwhelming backlog of delayed care to address? Yet amongst this backdrop, here comes the CFPC, not to try to find ways to support physicians or provide tools to help them be healthy so they can look after their patients better, but to berate, admonish and vilify them as a group. This is supposed to make things better? The type of evidence-free invective Dr. Ladouceur ran should never have been given any platform, much less a platform on an organization who’s mission statement includes advocacy on the part of the specialty of family medicine. Frankly, I’m embarrassed to be a member of the CFPC, though given the regulatory requirements to maintain my continuing medical education, I can’t resign from it. If the CFPC really wants to help, they will pull Dr. Ladouceur’s screed from their magazine, and apologize to all 40,000 family physicians in Canada. Anything less will suggest complicity and sympathy with his views, and will contribute to family physicians losing confidence in the CFPC. Dr. Sohail Gandhi has practiced rural family medicine since 1992. He's a former president of the Ontario Medical Association.

Tone deaf CFPC fails its members, embarrasses itself

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