Replacing the irreplaceable

The problem with most healthcare reformers is that they're unwilling to recognize the value of that excellent group of generalists: the family physicians. For decades family physicians have been providing most of the services the reformers say are to be provided by their much-vaunted "teams." Instead, the reformers have systematically devalued and ignored the work of family physicians, bombarding the public with subtle, and not-so-subtle, propaganda about our "not treating the whole person" and "not practicing preventive medicine."

Meanwhile, federal politicians and health bureaucrats, who burble on about the vital importance of preventive medicine, pay physicians virtually no attention when we try to promote the value of family practice. In this climate, fewer and fewer students are electing to do family medicine, with the result that the number of family physicians is rapidly dwindling. And those of us who remain are expected to do more and more with less and less. And now, when the stress and strain is beginning to tell on family physicians, the predictable response from the reformer is: "Let's blame the doctors."

Instead of doing something to restore a system that has proven itself many times over, the reformers want to replace it with a totally unproven system, whose cost will likely turn out to be astronomical.

As physicians, we've worked extremely hard to get to where we are, and we value our independence. When faced with the prospect of becoming anonymous "team members" doing shift work in government-run wellness emporiums, most of us will elect to specialize or get out of medicine altogether.

If the present trend continues, the family physician will almost certainly become a thing of the past, and I am reasonably certain that this is the unspoken goal of some reformers. They think it will be cheaper to replace family physicians with paramedics and nurse practitioners. While I have the greatest respect for both of these groups, I don't believe we can eliminate family physicians without doing an enormous and irreparable damage to our healthcare system.

I am hopeful that the public are fully cognizant of the value of their family physicians, and will resist radical changes being forced on them by healthcare planners. If, on the other hand, the public accepts the reformers' propaganda and chooses to go along with their plans, they will get the kind of healthcare system they deserve.

— Dr Anthony Rockel
Placentia, Newfoundland

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