50 years of Family Medicine
Jennifer Parraga, BA'93
Although it has been decades since Dr. John Sangster, MD’67, and his mother were caring for his ailing grandmother, the memories are still vivid. He clearly remembers the thoughtful, patient and caring approach of his family doctor.
“He supported us and gave us the comfort we needed, to know that we were doing the right thing for her,” Dr. Sangster said.
Years later, that same doctor invited Dr. Sangster to join his group practice, Wharncliffe Family Doctors, and delivered all of Dr. Sangster’s children.
It’s this opportunity for longitudinal relationships such as the one Dr. Sangster had with his family physician and which he experienced with his patients that he says is the essence of family medicine.
“I was a family physician for 43 years, and have cared for multiple generations of families, and had the privilege to live through unique experiences with many of them,” Dr. Sangster said.
A graduate of Family Medicine residency and master’s programs at Western University, Dr. Sangster is proud to have been associated with the Department for all of its 50 years. He served as Professor, Medical Director of the Byron Family Medical Centre, and Director of the graduate program. He is looking forward to the celebrations as the Department recognizes its golden anniversary in 2018.
Specialized family medicine training became available at Western in 1966, as one of only two such programs in Canada. At that time, medical graduates had the option to pursue training, with one year serving as an internship and then two optional additional years of specific family medicine training. Dr. Sangster was one of three individuals who chose to continue on following their internship in 1967.
As Dr. Sangster began his full first year of family medicine training, Dr. Ian McWhinney was recruited to Western University to become the founding Chair of the first academic Department of Family Medicine in Canada.
Dr. McWhinney, known as the father of Family Medicine in Canada, is considered one of the foremost writers and academic leaders in the discipline of family medicine in the world. He was responsible for developing and promoting the patient-centred, clinical method, which at the time was an insightful way of understanding effective doctor-patient communication. He also conceived of the Master of Clinical Science Program, which prepares family physicians for academic family medicine roles.
It took Dr. McWhinney five years to have the graduate program passed through Senate, and since it was launched, it has grown exponentially. Having just celebrated its 40th anniversary in 2017, there have been 106 graduates, from 17 countries across six continents. Collectively the graduates have generated 1,953 papers that have been cited more than 27,000 times. Since 1997, the Program has been offered in a distance education format online.
The Department now also offers a PhD program, offering family physicians the opportunity to pursue research at the highest levels. Dr. Stephen Wetmore, Chair/Chief of the Department says that Family Medicine at Western distinguishes itself from other programs from across the country through its significant clinical training opportunities and by serving as the intellectual centre for family medicine in Canada and serving as the source of many influential books, papers and presentations.
Many of those contributions come through the Centre for Studies in Family Medicine (CSFM), which brings together an interdisciplinary group of researchers working collaboratively on topics important to family practice and primary care.
There are several disciplines involved including epidemiologists, family physicians, social scientists, nurses, social workers and psychologists. The researchers support one another in their endeavors and are truly collaborative.
The work of CSFM has led to at least seven new models of care during the past four decades, including the patient-centered clinical method; an integrated model of home care combining family physicians and case managers; models of improved practice through enhanced information technology; care for children with mental health problems; care for indigenous people with diabetes; interdisciplinary care for patients with multimorbidity; and promotion of exercise in the aging population.
It has also made original contributions to research methods such as pragmatic trials design, methods related to measuring patient-centeredness; measurement of the natural history of symptoms and illnesses.
Dr. Barbara Lent, Professor in Family Medicine is proud to define herself as a family physician and to be joining in the anniversary celebrations.
“I’m really pleased to have been part of many of the Department’s initiatives, including the research program on family physicians’ role in addressing woman abuse and in various educational endeavours at all levels of medical education,” Dr. Lent said.
Dr. Tom Freeman, Professor and former Chair/Chief feels very fortunate to be part of, and to work with, so many individuals who make the Department a vibrant centre of intellectual work and the application of that work to the daily practice of family medicine.
“Ian McWhinney set out to show that a generalist discipline such as family medicine is not just a collection of parts of various medical specialties, but an academic discipline in its own right with its own methods of practice, unique questions and methods of inquiry and is capable of making a unique contribution to medical practice,” said Dr. Freeman. “I think the Department that he founded has made great strides in this direction and will continue to do so in the next 50 years and beyond.”
Dr. Wetmore is looking forward to the activities that are being planned to celebrate the Department’s anniversary including a special lecture featuring Western alumnus, Dr. Danielle Martin, as well as the annual McWhinney Lecture.
With more than 1,000 family physicians trained in the past 50 years, Dr. Wetmore is proud of the Department.
“When you consider our history, the comprehensive training we provide, the fact that our training is based on solid research that is being generated in the CSFM, we are a premier family medicine training program that is serving the residents of Southwestern Ontario and indeed the world,” said Dr. Wetmore.
The past 50 years have been critical in the development of family medicine and Dr. Sangster is excited to watch the next few decades unfold.
He encourages young medical students considering family medicine as a career to explore the true meaning of the doctor patient relationship, experience a variety of clinical disciplines, as well as urban and rural family medicine opportunities, and to consider what lifestyle they want. He believes that if the longitudinal relationship with patients appeals to them, they will have a rewarding career in family medicine. In so doing, they will continue the legacy of the Department of Family Medicine at Western.