What is a Family Doctor Good For?

 

Have you ever heard your family or friends from back home tell you this?

"Don't bother going to the family doctor, you should go see a specialist for your problem."

"Family doctors know a little bit about many things, but not alot about anything."

 

When  you come to Canada, you will learn that Canadians are very proud of their health care system (or at least the ideals of what it should be like), and the success of their system is based on strong primary care. Leading the primary care system are specialists called Family Doctors.

"In my home country, when I have stomach pain, I go to the hospital and see a gastroenterologist (intestinal specialist) and get a colonoscopy right away!"

Beware of playing choose-your-own-adventure medical care, do so at your own peril !

In Canada, patients need to go to their family doctor first for any non-emergency medical problems. The hospital emergency department is reserved for people with emergencies (like you are going to die or be severely disabled if you don't get immediate help). You can go to the emergency department (ED) or emergency room (ER) for your problem, but you will likely wait for hours, be seen for 2 minutes by a busy ER doctor, and then be kicked out and told to see your family doctor anyways. You can try to go to a walk-in-clinic (WIC), but those doctors do not consider themselves your family doctor, as they only deal with your one-time specific problem, and then tell you to find a family doctor. Meanwhile, you would have wasted so much time, money and effort, when you could have just seen your family doctor in the first place.

"But, I think the general practice doctors (GP) in Canada must be similar to the general practitioners / doctors in my home country!"

In some countries, most doctors train to be specialists because there is no such thing as a family doctor. In some countries, the doctors who aren't specialist but see general simple problems, may only have basic medical training (starting right after highschool) because they couldn't study any further or couldn't climb up the hospital ladder. These rural general practitioners may do alot because they have to, and their experience gives them the needed skills. It is understandable, that you may insist on "seeing the best", and "the best must be a specialist."

In Canada, doctors need to have finished a university degree before even applying for medical school. Most doctors don't even get to go to medical school (get an MD) until they have finished a Masters, or even a PhD! For the lucky few who are admitted to medical school after a Bachelor's degree, they are usually considered to be at the top of their class. All doctors trained in Canada go through a minimum 4 years of an MD degree. Then they do more training in residency, another 2-3 years. The specialists only start their specialty training after that when they decide to focus on one particular medical field. By then, they are relieved that they don't need to remember the other medical fields, because they will have nothing to do with their own chosen specialty.

In the past, there were a breed of Canadian doctors called general practioners (GP), who only finished 1 year of rotating internship after their MD degree, and became family doctors for the Canadian population. However, their ongoing years of continual medical education (CME) learning and decades of on-the-job experience made them valuable and highly qualified to diagnose and manage your health.

As science progresses, and as people live longer, there is an ever increasing body of knowledge that a doctors needs to know. The textbooks are thicker, people's medical problems became more complicated, and so emerged the specialty known as Family Medicine. All family doctors that graduate now from the Canadian medical system must be trained in the specialty of Family Medicine (a minimum 2 year post-graduated program).

So if you want a "specialist" to be your family doctor, then you should find a Specialist in Family Medicine (with the certification CCFP).

Family Medicine specialists are trained to take your problem or symptom, which could be caused by hundreds of different things under the sun, and rapidly narrow down the possibilities to make a diagnosis. For all the problems that are not diagnosable (NYD), they can at least tell you that it is a benign condition (not a serious problem), because they have seen alot of conditions under the sun. You can rest well at night with confidence. Not only can these family doctors diagnose, they also treat and manage your conditions. That's right, in Canada, family doctors treat the majority of specialty conditions for the general population. There is not enough medical specialists (nor money) around to have everyone see a medical specialist. Family Medicine specialists have trained alongside other medical specialists to develop competencies in areas such as: cardiology, gastroenterology, respirology, endocrinology, obstetrics and gynecology, pediatrics, psychiatry, neurology, nephrology, otolaryngology, opthalmology, dermatology, urology, hematology, general surgery, rheumatology, orthopedics, emergency medicine, infectious diseases, geriatrics, radiology, and more! A large proportion of medical burdens such as hypertension, heart disease, diabetes, asthma, COPD, arthritis, pediatric care, women's health, and mental health are managed by mainly by your family doctors.

"So when can I see a real specialist?"

When your particular family doctor cannot manage your specific problem because of time, experience, or complexity, then you doctor may refer you to see a specialist. That's right, to see a medical or surgical specialist in Canada, you need to be referred by a family doctor, after having assessed you and making a medical judgement that your problem warrants a specialist. Otherwise, your family doctor will have been able to assess, diagnose, and provided the medically necessary treatment to you already. If your family doctor recommends surgery, then they will refer you to a surgeon. If your family doctor recommends seeing a specialist, then they will refer you to a medical specialist.

If you go, yourself, to a medical or surgical specialist with a problem that ends up not being part of the particular specialist's field of medicine, then they will likely tell you to go home and see your family doctor. It is not the specialist's problem. They can't be bothered by you. It is still your problem, and you are not satisfied. Do yourself a favour, see your family doctor first and let them determine what the right course of action is for caring for your whole person.

"But I don't need a family doctor now. I just ask Dr. Google when I have a problem!"

That may be the case. However, when you do need a doctor, you will need a family doctor. But when you want a family doctor, you may not be able to find an available family doctor. Therefore, find yourself a family doctor now, so when you eventually need medical care, you will have an existing doctor-patient relationship to draw upon for help.

Besides, Dr. Google brought you here, and we're telling you to find a family doctor. So Dr. Google must be right!

"I went to a family doctor / walk-in doctor, and he mis-diagnosed me!"

Sorry about your experience. That sounds terrible. Mistakes do happen in medicine. Medical problems can also be an evolving process; meaning at the early stages of an illness, you may not show all the signs and symptoms, and it could still be several different possibilities. Diagnosis is both an art and science. This is the challenge of Family Medicine, making the diagnosis when it is not blatantly obvious. There are also bad doctors out there. However, a majority are good doctors, and they do have your best interest at heart. They've studied, and worked hard to be the best at what they do: to make the right diagnosis and manage your health. Find yourself a good doctor. If you are not getting better, or your condition is getting worse, then go back to your good doctor, and they will reassess the situation. This helps prevent missing something important that is slowly evolving.

"So you are telling me that Family Doctors are Specialist?!"

Family Medicine is considered a Specialty. AAFP. CPSO.

Did you Know...?

Did you know that the doctors you might see in the emergency department, or take care of you in the hospital ward, or deliver your babies are Family Medicine specialists (CCFP) who have additional training in emergency medicine, obstetrics, or internal medicine fields? You think you are seeing a regular specialist, but really you are seeing a family medicine specialist! If they're good enough for Canadians, then its good enough for you!

So are you feeling lost in the healthcare system?

The practice of Family Medicine is meant to be a Patient's Medical Home, providing seemless care, through all the stages of your life, and integrating with your other health services.

At Get Well Clinic... We Welcome You Home!