What will medicine look like without any family doctors?

I have been a family doctor since 1992 and I have seen the respect and appreciation of family medicine dwindle considerably over these 30 years. Family doctors, like me, have been cajoled to leave hospital care in cities. Family doctors continue to be at the lowest quartile of income. Family doctors have the highest amount of gender pay gap with pediatricians and psychiatrists. Family medicine residency positions continue to be unmatched at higher and higher levels. When the policy-makers make family medicine completely untenable then we need to consider what will medicine be like in the future if there were no more family doctors? Welcome to the future. Nurse practitioners (NPs), who can do most of the work of family doctors now, will diagnose all medical conditions, refer to all necessary specialists, refer for all diagnostic imaging (including MRI and CT), can prescribe all treatments including controlled substances, and will be paid an annual salary, a pension and medical insurance (without overhead costs). How many NPs will we need? Will they be provincial or federal employees? Will Choosing Wisely be important? Whatever happens outside of NPs' office hours can be managed by pharmacists or sent to the ER since ERs will have lots of openings. Read: Dr. Alykhan Abdulla: I love family medicine but I'm worried and frustrated Pharmacists will diagnose all medical conditions and provide treatments for all conditions (including asthma and cirrhosis and amyotrophic lateral sclerosis). How many conditions require a prescription? Pharmacists will provide all vaccinations to babies, teenagers and seniors (in addition to flu and COVID-19 shots). And whatever is not covered can be purchased. And they can review every medical condition and renew medications. Would anyone ever need to lower or stop taking medications? Of course they will order lab tests and diagnostic imaging, refer back to NPs and specialists (who work in their pharmacies). Midwives will be fully autonomous practitioners who manage comprehensive prenatal and postnatal care for mother and child(ren), direct referral to ob-gyns, all in-office procedures and access to all associated testing and imaging. In the future, their scope will be expanded to providing sexual health advice to young women, managing STIs, doing prenatal ultrasounds, dealing with intimate partner violence, placing in IUDs, vaccinating babies and sending direct referrals to pediatricians. The real expansion of care will be with naturopaths, physiotherapists, chiropractors, massage therapists, acupuncturists, audiologists, social workers and counsellors who will manage all kinds of medical conditions with full coverage by the province. They will order lab tests, diagnostic imaging, refer back to NPs, pharmacists and specialists, and ensure optimal health for their clients. The right care by the right practitioner at the right time. There are also new roles for administrators who will help pharmacists, midwives, psychiatrists, NPs, and pediatricians to roster/register patients and ensure they meet new quotas of efficiency. These administrators will become the fief lords of community care. There would be no orphaned patients. There would be no wait lists. Finally all of the family doctors will become specialists (or administrators) and all medical students will go into the Royal College. An amazing future lies ahead of us! Dr. Alykhan Abdulla is a family physician and the medical director for the Kingsway Health Centre in Manotick, Ont.

What will medicine look like without any family doctors?

Register for free access or login.

Related Topics