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Family Medicine Professional Profile

The Family Medicine Professional Profile is a position statement that defines the discipline of family medicine, describes the scope of practice and training for family physicians, and highlights our philosophy of care.

The Family Medicine Professional Profile is the College of Family Physicians of Canada (CFPC) position statement for the discipline of family medicine. It communicates the collective contributions, capabilities, and commitments of family physicians to the people of Canada.

PRIMARY RESPONSIBILITIES

Working together, family physicians provide a system of front-line health care that is accessible, high-quality, comprehensive, and continuous. Individually they take responsibility for the overarching and proactive medical care of patients, ensuring follow-up and facilitating transitions of care and/or referrals when required.

More than a series of tasks, it is through relational continuity and a commitment to a broad scope of practice that the complexity of care is meaningfully addressed. The care family physicians provide improves the overall health of the population. The principal aims of the CFPC are to set educational standards for family physicians and to develop, support, and sustain family physicians in the provision of:

  1. Comprehensive medical care for all people, ages, life stages, and presentations. This care includes all clinical domains, both acute and chronic, and all stages, from preventive to palliative care. Family physicians work across care settings and regulatory environments, including:
      • Primary care
      • Emergency care
      • Home and long-term care
      • Hospital care
      • Maternal and newborn care
  1. Leadership at all levels for accessible, high-quality, comprehensive, and continuous first-contact health care that responds to local conditions, and for research that advances an understanding of this care.
  2. Advocacy for access to culturally safe, affordable, high-quality, and comprehensive health care, along with the social conditions that promote health. This requires outreach and engagement, such as working with community partners and including patients experiencing hardship and/or barriers to care.
  3. Scholarship (teaching/quality improvement (QI)/research) as reflected in practice-based QI activities, an evidence-informed approach to care, and in the roles of teacher and mentor. Family physicians advance the knowledge of the discipline through a continuum of research activities.

WORK SETTINGS AND ARRANGEMENTS

Family practices are a cornerstone of the Canadian health care system, functioning as hubs of access and coordination. Family physicians commonly work in teams, and the CFPC advocates for the uptake and support of the Patient’s Medical Home model as a means of achieving accessibility, comprehensiveness, and continuity in a way that is both personally and professionally sustainable.

Family physicians collaborate and share an interdependence with other health care professionals, contributing medical expertise in clinical care and leadership to ensure practice quality and continuous improvement. Family physicians with enhanced skills work in collaborative arrangements, where possible, to extend the comprehensiveness of care provided locally while supporting continuity and sustainability and leading improvements in education and the adoption of models of care that support this integration.

SPECIAL FEATURES AND CONTRIBUTIONS

All family physicians, regardless of the nature of their practices, embody a characteristic approach that strengthens the compassion, responsiveness, integrity, and quality of the health care system. This approach drives the provision of care that is:

Relationship- and patient-centred: Relationships are central to the care provided. Family physicians are committed to the person; they get to know them and what matters in the context of their life and family, and this informs the goals of care and the approach taken. They form therapeutic bonds based on compassion and personal knowledge accrued over time, which allows them to offer trusted counsel and advocate on behalf of their patients. It is within these relationships and their unfolding narratives that illness and suffering are recognized, understood, and mitigated.

Community-adaptive: Family physicians are a resource to their practices and communities as highly skilled generalists, working effectively in diverse environments, addressing complex conditions, and managing uncertainty. They manage a broad range of medical presentations and conditions, flexibly adapting their skills in response to local resources and care needs. Family physicians use holistic, integrative reasoning to reach a patient-centred diagnosis and treatment plan, with particular expertise in managing patients with multiple morbidities and chronic illness.

They see patients with undifferentiated concerns early during the natural course of illness and think creatively to resolve complex and/or atypical situations. In challenging situations, family physicians work to the limit of their abilities when required, staying involved and comitted to ensuring patients receive the necessary care and support. This versatility and dedication enables family physicians to play an important role in responding to ever-changing, novel, and emerging health challenges affecting their patients and communities, and this adaptiveness is a key motivator for family physicians to develop enhanced skills.

Collaborative and continuous: Family physicians are the drivers of cohesion and continuity in the health care system. They work collaboratively with patients and practice colleagues to coordinate care with other health care providers. Continuity occurs both within episodes of care and over time, and it encompasses dimensions of interpersonal relationships, the maintenance of medical records, and the organized flow of patient information, including unique considerations that support personalized and compassionate care.

SKILLS AND TRAINING REQUIRED

Certification in the College of Family Physicians (CCFP) of Canada is a CFPC Special Designation with eligibility granted to those members who have completed approved residency training in family medicine or become eligible for certification through a combination of approved training, practice experience, and a commitment to continuing professional development (CPD). Once eligible, individuals are granted certification by successfully completing the Certification Examination in Family Medicine. Ongoing certification is maintained through participation in the Mainpro+® program, which defines the CPD required of family physicians and the quality criteria expected of learning programs.

Residency training prepares family physicians for the professional activities outlined in this profile. The many competencies required are outlined in CanMEDS–Family Medicine and programs are designed to develop these competencies according to the Triple C Competency-Based Curriculum.  The determination of an individual’s competence to enter independent practice is guided by the evaluation objectives in family medicine, using a programmatic approach to assessment. The Specific Standards for Family Medicine Residency Training Program (The Red Book) outline the standards used to accredit family medicine and enhanced skills residency programs based in departments of family medicine at Canadian universities.

Certificates of Added Competence recognize the achievement of additional competence in specific family medicine domains for which the CFPC has defined eligibility and approved standards of assessment.

WHY WAS THE PROFILE DEVELOPED?

Standard setting:

To guide the development of educational standards with a clear description of the work of family physicians in keeping with a competency-based medical education (CBME) paradigm.

Social accountability:

To describe the collective commitment of family physicians to the people of Canada. To articulate the contribution of generalists and generalism in family medicine, introducing the concept of community-adaptiveness.

Communication:

To better inform others (partner organizations, policy-makers) about the role and scope of family physicians and to guide our messages to medical students about family medicine as a career.