Chair's Message

This month the Department of Family Medicine is marking the 50th anniversary of the academic department, one of the first departments of family medicine established in Canada!

General practice teaching was in place in London as early as 1965, however, in 1968 Dr. Ian McWhinney was recruited to London and established as the first Professor of Family Medicine in Canada. We are therefore using this year to mark our anniversary.

Now, 50 years later, our Department has graduated well over 1000 family doctors and continues to provide excellent clinical care, education and research in primary care.

What remarkable changes have taken place over 50 years.

In the early days our graduate family physicians had broad scopes of practices including work in the community, hospitals, emergency rooms and obstetrical suites and included just about everything in their practice.

Along the way Family Medicine became a specialty of its own, specialists in generalism, comprehensiveness, patient centeredness, and our hallmark, the long-standing trusting relationship between patient and family doctor.

Gradually over time family medicine has changed from the provision of broad scope care by one physician, to the provision of care by teams including family physicians and other health professionals. Family physicians have focused more on care in the community and less on care in hospitals, unless they are in a special focussed practice such as hospitalists, palliative care physicians, GP oncologists etc.

In one sense the move to more specialized areas of practice is occurring because it is harder and harder to be a competent generalist family physician as there is so much to know and so many standards to meet in individual areas of practice. A sign of the times is the recent CPSO policy on providing care in rural emergency departments. This policy essentially questions whether urban trained family physicians have enough skills to work in rural hospital emergency rooms. This is one of several issues that has highlighted the gap between urban family doctors and our rural colleagues, and raised difficult questions for our family medicine training programs.

So, after 50 years of family medicine training, questions and challenges still remain. Will we stay together as a discipline or will we settle into multiple camps, e.g. generalists vs specialists, urban vs rural? What will the next 50 years mean for our discipline?

As always I welcome your questions and comments. or @DOCSJW on Twitter.