Primary care ads send the wrong message

A number of our members have expressed concern that the recently completed national TV, radio, and newspaper ad campaign promoting primary care made no mention of family doctors, leaving an impression that patients should seek their primary medical care from “teams” of health professionals rather than from family physicians. These ads were part of a government-subsidized Primary Health Care Transition Fund project, the stated objective of which was to increase the public’s understanding of primary care and primary care teams. Before launching the campaign, project leaders met with the College of Family Physicians of Canada to seek our comments and endorsement or partnership. While we support many primary care renewal initiatives, including appropriate team approaches, we believed this campaign ignored the essential roles of Canada’s family physicians. Because the strategy was developed before we were approached, and because no changes were made following our discussions, we decided not to endorse or partner in the campaign. We considered expressing our concerns about the ads publicly, but concluded that doing so would only bring more attention to them. We were also advised that our protests could lead to misinterpretation of our position, painting us as opponents of many of the progressive primary care strategies—including appropriately defined “teams”—that we in fact support. For the first year that these ads ran, neither the public nor physicians seemed very aware of them. Through February, March, and April of 2006, however, the campaign intensified and became more visible. Many family doctors were rightly upset, though how much the ads affected the public remains questionable. Our informal canvassing indicated that most people were either unaware of the campaign or did not know what the message was supposed to be. The CFPC’s response to both this and other government initiatives (such as Ontario’s ads suggesting that nurse practitioners are available to diagnose, treat, and prescribe as doctors do) is manifold. Our most pointed concern is directed toward governments, which must be made to understand that promotion of new primary care models is fine, as long as it is presented without ignoring or demeaning the role of family physicians. The CFPC supports our colleagues in other health professions in their goal of gaining greater understanding and respect for their roles on health care teams. We do not, however, support models that promote others as substitutes for family physicians as the main providers and coordinators of medical care. Evidence shows that better health outcomes are directly related to patients’ having a primary care physician.1 As well, in every public survey, nearly all Canadians clearly indicate they highly value family doctors and want better access to them. The CFPC and its Chapters believe it is time for the public, governments, medical schools, and all other health care professions to acknowledge family medicine as the special discipline it is, with a unique role and value equal to every other medical specialty. We are lobbying for greater practice supports for family doctors, including increased remuneration to eliminate the inappropriate gaps between the incomes of family physicians and those of other specialists. We have established family medicine interest groups in every medical school in Canada and introduced medical student leadership awards and scholarships. We have a task force looking at changing undergraduate curriculum to ensure increased and appropriate roles for family physicians in medical school education. The negative effects of the poorly conceived messages found in the recent primary care ad campaign are relevant to both practising family doctors and medical students. The experienced physicians see these ads as a betrayal of the excellent care they have provided for Canadians for decades. Medical students considering their future careers see these ads as dismissing the relevance of family medicine and making it seem to be of lesser value than other specialties. If these messages reduce the number of current and future physicians in family practice, then the long-term goals of Canada’s health care system shared by all—including governments—will become unachievable. To reach those goals, we support family physicians both in traditional and in new and emerging models of primary care, including team models of care. Fortunately, despite the recent ad campaigns, the past 2 years have seen the start of a turnaround, with increases in the number of medical graduates selecting family medicine. During this time many of our federal and provincial governments have subsidized projects and partnered with our College on initiatives intended to increase support for family medicine. The CFPC appreciates this and will continue to work with governments and the other health professions to help them better understand the essential role that family doctors must play in the future of health care in Canada.

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