President's Message - March 2017

David White, MD, CCFP, FCFP

Leadership in turbulent times

These are turbulent times. It seems every day brings fresh news of conflict, controversy, and commotion. Turmoil is unrelenting in international and national politics. Health care is caught up in controversy, as well. The most prominent arguments are about paying for health care, including the topics of what are acceptable costs, who should pay, what is the role of government, and how we pay physicians and other health care workers. These discussions are not limited to direct financial aspects; lively debate extends into such areas as what services should be covered, which providers can offer specific services, and what constitutes “needs” versus “wants.” We also discuss the important matters of access to care, workloads, lifestyle, standards, and regulation.

When debate becomes more impassioned it seems to generate more heat than light. Facts are ignored, twisted, or used selectively. As physicians we are acutely aware of the need to ground clinical practice in solid evidence. Yet it seems much more challenging to do this in the realm of health care policy, in part because of the evidence itself. We are intimately familiar with the reality that the “best evidence” in any scenario continues to evolve. At times the evidence changes rather abruptly: It can shift with a new discovery, when an old research study is exposed as deeply flawed, or when a drug that was once the “latest and greatest” is ultimately revealed to carry significant risks. In policy, as much as in clinical care, we need to actively produce and scrutinize the best evidence.

The fundamental roles of the College of Family Physicians of Canada (CFPC) are to provide leadership to the profession and offer guidance and support to our members, particularly during times of change.

Several important pillars contribute to the strength of the CFPC. Articulating the well-established value of the role of family physicians in a strong primary care system is crucial. Many political leaders appear to understand this basic fact. Still, translating understanding into strong support for the Patient’s Medical Home model and equitable financial support for providing comprehensive, continuing care remains a challenge. Supporting high-quality research is essential, as is providing a forum for the dissemination of this work and informed debate. The engagement of our members is one of the most important foundations for all of this.

As CFPC President, I have the privilege of witnessing this engagement directly in the individuals who participate on our numerous College committees, in Chapter meetings, and in members’ forums. The strength of our profession depends on this commitment—especially in these turbulent times.

David White, MD, CCFP, FCFP

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