Why Family Medicine?

A Fact Sheet for Prospective Family Physicians

  • More than 90% of Canadians indicate that a family physician is the first person they would turn to in order to address their medical problems
  • 66% of Canadians believe family physicians are the most important health professionals they see
  • On average, 1 additional family physician per 10,000 people is associated with a 5.3% reduction in mortality

Family medicine offers challenges, flexibility, and tremendous diversity. Family physicians provide comprehensive care for patients and their families within the community, with a focus on prevention, management of chronic disease, and coordination of care. Family physicians have the opportunity to provide care in a variety of settings, including medical clinics, emergency departments, acute care settings, and in patients’ homes. Some work internationally providing care to people in low-resource countries. With many physicians working in teams and with other health professionals such as nurses, occupational therapists, and nutritionists, the field is also becoming more collaborative.

Training for a career in family medicine

Family physicians are often the first line of care, and care for patients when they present with illness through the management of chronic diseases.

Students should consider family medicine if they:

  • Are interested in being generalists; family physicians specialize in breadth rather than depth of knowledge, amassing an equal but different knowledge base to specialists
  • Enjoy diagnosing and managing the undifferentiated patient: family physicians have the opportunity to see patients from their first presentation, and to manage their care both independently and in partnership with other medical professionals in the community
  • Are attracted to a number of different specialties and want their practices to encompass a wide range of disease presentations
  • Want flexibility and control over their schedules
  • Want to form long-term relationships with their patients

Diversity in patients, work settings, and schedules makes family medicine the most flexible career in medicine. A variety of practice models, the opportunity to job share, and the ability to shape their practices offer family physicians a great deal of choice. The high demand for family physicians in almost every region of Canada also opens many opportunities for locum positions and travel.

Some family physicians also choose to incorporate a focused area into their scope of practice. Nearly one-third of family medicine residents complete additional training to better prepare them for the patients they will encounter while serving their community’s specific needs.

Students may also pursue training through Enhanced Skills (R3) programs, ranging from a few months to one year. In 2008–2009, 196 R3 positions were available in Canada for family medicine residents. At some schools, prospective students can secure funding to support an R3 training program based on their unique career goals; availability and focus vary by school. Examples of Enhanced Skills programs include emergency medicine, sports medicine, geriatrics, women’s health (obstetrics, gynecology), adolescent medicine, mental health, research training, substance abuse treatment, international health, and HIV/AIDS.

A career as a family physician

Research from the Canadian Institute for Health Information indicates that approximately 53% of Canadian physicians are family physicians or are in general practice.

Data for family physicians according to the 2007 National Physicians Survey:

  • Average work week: 49.8 hours
  • Average time spent on patient care/week: 29.8 hours (with an additional 3.6 hours spent on patient care in conjunction with teaching activities)
  • Average time away for personal leave/year: 4.4 weeks
  • 31% practiced in small towns, rural areas, or geographically isolated regions
  • 33% worked in community hospitals, 23% in emergency departments
  • 11% practiced obstetrics, delivering infants
  • 51% were in group practice, 23% were in interprofessional practice

Medical schools in Canada are expanding and their curricula are evolving to include more family medicine-focused teaching and research opportunities. Family physicians are increasingly involved in senior leadership and teaching roles. The Canadian Institutes of Health Research recognizes the importance of primary care research and is increasing the funding for research in this area.

Family physicians are generalists who need to be comfortable managing any medical issue that comes through their door. They have the opportunity to diagnose a wide range of illnesses in that they often see patients early on in the course of their illness. Through the opportunity to provide ongoing care, family physicians can also establish deep connections with their patients and the communities they care for. Family physicians reinforce and strengthen their medical knowledge through their work with patients, interactions with colleagues in the medical community, and formal continuing professional development opportunities.

What is the average income for a full-time family physician?

Income for family physicians varies widely depending on hours, location, incentives, and type of practice. Within a group practice, family physicians should earn over $175,000 after overhead and before taxes. Because governments are starting to realize the importance of continuing comprehensive care, in many parts of the country there have been of improvements in compensation for chronic disease management, with family physicians earning more than ever for providing such care.

Incentives for practicing in underserved areas range from higher salaries and higher fee-for-service payments to loan forgiveness, lump-sum payments, increased continuing medical education, and holiday support. Most rural physicians have lower overhead costs and the opportunity to earn higher income for performing procedures that would otherwise be carried out by other specialists.

The future of family medicine

Many factors are attracting medical students to family medicine, including newer care models and better working conditions, improved training, support to establish electronic medical record systems, and better financial compensation for chronic disease management. To learn more about these reforms, please review the Primary Care Toolkit for Family Physicians developed by the CFPC.

The CFPC is also recommending that the concept of a medical home be incorporated into primary care settings across the country. A medical home is a patient-centred care setting where patients have a personal family physician who provides and directs their medical care. Medical care is coordinated, continuous, and comprehensive, with a focus on providing care for the whole patient in conjunction with an interprofessional team. Read more about the medical home in the 2009 discussion paper, ‘Patient-centred primary care in Canada. Bring it on home’.

In the midst of Canada-wide and global shortages of family physicians, the Canadian government is realizing that a robust primary care system is vital to the sustainability of our health care system. Will you be the future of family medicine?

Authored by:  
Ian Scott MD MSc DOHS CCFP FRCPC FCFP (Vancouver, BC) 
Goldis Chami BA BSc (Vancouver, BC)

Special thanks to all of the medical students who have contributed their feedback.

This article has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

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