Letters in the AMA Doctors' Digest

There's been a lot of focus in medical school today regarding entering family medicine practice. Many students today are choosing specialty medicine over family practice.

Family physicians are extremely important in healthcare. The majority of people in Canada rely on their family physician to provide their daily healthcare needs. They follow patients' health problems, both acute and chronic. If a patient does not trust their family physician, they most likely will not trust the rest of the healthcare system.

There are a number of excellent reasons to choose family medicine as a medical student, including the ability to run your own practice, to choose your own hours, and the ability to follow your patients for a number of years.

In the most recent issue of the Alberta Medical Association Doctors' Digest (May/June edition), they featured some member feedback on physicians possibly considering a career change. Here's what some people had to say:

“I am considering a career change. . . . The very significant lack of fair compensation for work done, responsibility assumed, is a major influence. The tremendous demand on time has impacted my personal life irreversibly and it is time to care for myself, my family, as ardently and thoroughly as I have cared for patients.”

“I will be retiring because of a number of factors: poor remuneration for family practice; ever-increasing office costs related to computerization/privacy legislation/licensing fees/staffing salaries; increasing paperwork demands related to insurance/medical-legal reporting; the unwanted push to join primary care networks with the paradoxical result of further fragmentation of patient care; increasing difficulties in getting speedy patient consultations, the frustrations of having to fill in multiple forms, arrange/book more preliminary testing before a specialist will agree to see a patient. Never have waiting times been so long (thanks to 1994 gutting of the medical system, subsequent loss of many excellent doctors).”

“I am considering retiring as I see family medicine losing the personal touch. By political design and with the willing acquiescence of 'political' doctors . . . the doctors are to be technicians and no longer doctors.”

“I have changed my career path within the last four years from 100% delivery of medical care to patients to a 25-30% patient contact: 70-75% administrative work mix. This is not as professionally rewarding but it offers better flexibility as a mother and, sadly, is more financially rewarding.”

“Reasons to leave practice: increased institutionalization of practice via increasing numbers of programs giving RHAs power to interfere with the delivery of primary care, threatening professional independence and autonomy; increasingly heavy workloads for those providing comprehensive primary care; relatively poor remuneration for those providing comprehensive primary care. . . .”

It seems as the feedback was quite one-sided, as I'm sure there are a number of family physicians who love their practice and patients. However, I think that what is represented in these views should be presented to medical students along with the pros of becoming a family physician so that students can make a choice for their career which best suites their personality and goals for the future.