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Can you run a family medicine clinic without board-certified family physicians?

Doctors petition to protect term “family medicine”

Family physicians from across Canada are urging their college to make “family medicine” a protected term. Concerned that non-physicians may be misleading the public about their qualifications, one group has collected close to 500 signatures in a petition to the president of the College of Family Physicians of Canada (CFPC).

“When people see ‘family medicine,’ they assume it refers to someone with a medical degree and board-certified family medicine training,” said Dr. Alexandra Power, a family physician in Ontario involved in the petition. “They don’t understand the difference between a naturopathic doctor and a medical doctor. I feel that these terms are now being used to mislead the public.”

According to Dr. Quynh Nguyen-Giang, a family physician from Ontario who is also involved in the petition, “There is a safety issue for patients to be misled or confused about who they are seeing when they go into a clinic.”

In response to the petition, Dr. Francine Lemire, CFPC’s executive director and CEO, explained that the college is considering the issues raised. It will require reaching out to the Federation of Medical Regulatory Authorities of Canada and some CFPC chapters, holding internal discussions, and reflecting on the topic in terms of resource management. It could be a complex initiative, suggested Lemire, depending on how it’s approached. In the meantime, CFPC is surveying its 38,000 members about their views on the matter.

Examples of misuse of the term “family medicine” by non-family physicians abound. One cited by Power and Nguyen-Giang is HomeMd. The Toronto-based company claims to provide a fresh approach to family medicine. Despite its name, claims and the images used on its website, no family physicians provide medical services for the company; all services are provided by nurse practitioners.

Terms like “family health”, “family care” and “family practice” can also be found on some naturopathic clinic websites. The Canadian Association of Naturopathic Doctors (CAND) 2017 awareness campaign used the slogan “Medically trained. Naturally focused.” The campaign’s website shows practitioners in white coats with stethoscopes around their necks.

How naturopaths promote their services has been of concern to some physicians for decades. “We see all sort of things,” says Dr. Linda Leblanc, a radiation oncologist in New Brunswick. “It touches all physicians, beyond primary care. Emergency medicine physicians pick up catastrophes post-cleanses. We need to be able to report those incidents.”

Leblanc was instrumental in an injunction sought by the New Brunswick College of Physicians and Surgeons to stop naturopaths from using terms such as “medical practitioner” and “family practice” to describe themselves or their services.

“Naturopaths are not medical practitioners, and naturopaths are not allowed to use words to suggest that they are,” ruled the Court of Queen’s Bench of New Brunswick.

According to CAND, however, the term “family medicine” has a broader meaning. “Family medicine is generally defined as the provision of health care to all members of a family. Naturopathic doctors provide naturopathic family medicine,” Shawn O’Reilly, CAND’s executive director, wrote in an email.

CAND was not aware of any effort by family physicians to restrict the use of the term “family medicine,” wrote O’Reilly. “In fact, naturopathic doctors work collaboratively with family physicians right across Canada.”

The CFPC recognizes and welcomes the contribution of others to a medical home but insists that family medicine is still the exclusive territory of family physicians. “Family practice, in 2019, is a team-based sport,” said Lemire. “This said, we believe that family physicians practise family medicine.”

Photo credit: Eyemark/iStock

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