World Family Doctor Day: 5 Minutes with Dr. Christie Newton

Dr. Christie Newton

Meet Dr. Christie Newton CCFP, FCFP, President of the College of Family Physicians of Canada (CCFP)! She graduated from medical school at Queen’s University in Kingston, Ontario, in 1995, and completed her family medicine residency in 1997. She earned her Certification in the CCFP in 1997 and her Fellowship in the College of Family Physicians of Canada (FCFP) in 2011.

Celebrate World Family Doctor Day and continue reading to gain valuable insights into Dr. Newton’s perspective on the necessary changes and advancements required to advance primary care in Canada.

1. What were the biggest challenges faced by family physicians during the COVID-19 pandemic?

Family practice and how we practiced changed overnight. On March 11, 2020, when a pandemic was declared and the world kind of stopped, practice kind of stopped, we didn’t know what to do. We wanted our staff to be safe. We wanted our colleagues and ourselves to be safe. We wanted our patients safe, in general, they’re coming to us because they’re sick anyway and we didn’t want to get them sicker if we didn’t treat them appropriately or manage the potential for infection.

Family medicine at its core is a relationship-based profession. Family physicians have an interest in solving some sort of medical puzzle that involves curiosity and variety across the lifespan. You never know what’s going to come next. It comes down to knowing your patients, their lives, their families and their communities. It’s more than just the issue that they’re coming in with.

Now being virtual, we focus on how to make that connection and make sure we are addressing and maintaining their care. For many patients that meant telephone, relay telephone triage, which is always challenging and not great for managing a lot of additional issues. You miss the conversations and statements that come up and the visual cues that you get from your patients in person.

When we finally got the flow of PPE and a little bit more understanding of COVID, we were able to re-establish some sort of systematic practice. However, it was hard to move staff to remote work. In the meantime, we were installing health and safety measures like plexiglass that were recommended for practice.

The hardest part was maintaining those relationships and providing the care that we’ve built generations upon providing in that shift. Now we’re getting back to it and we’re slowly figuring out how to maintain that virtual component which supports some of our frail elderly patients or our patients with accessibility issues. It also improves access to some of our rural and remote patients, as we transition back to what we think of as the foundation of family practice.

COVID was challenging, but we’re really seeing hope and optimism again about the practice and getting back into, as I say, our “comfort zone” of how we were trained and, and what we think of as family medicine.

2. What changes and improvements do you believe are necessary for the advancement of family physicians in Canada?

There is a primary care crisis. There’s a family medicine crisis. Fewer and fewer medical students are choosing family medicine, and we want to know why. It’s a great profession. I love it. I would recommend it to anybody. 

The problem with family medicine right now is family practice. While we train to look after patients and care for patients and communities, we end up running a business and the business model is horrible. We have no control over our fee for service. Our practice expenses and operational costs are increasing like all other businesses, and that detracts from providing quality care. The system is set up to push volume, not quality. 

To improve and stabilize family practice and address the crisis, we need to reorganize the system. We need to provide infrastructure to support family doctors providing care as opposed to doing paperwork, staffing work, and inventory operations. 

Creating community health centers where the center and the other professions are funded will allow family doctors to again focus on some sort of leadership and care. Team-based care ensures that physicians can work to the full scope of their training and manage the complexity of care and the system. Family physicians are supported by nurse practitioners, physiotherapists, social workers or mental health counsellors. All these people could improve access to primary care and share the load and have the most appropriate person do the care. 

Technically, in our current system, the family physician is the most responsible provider, however, they may see another provider who is most suited to the problem. For example, if they have a musculoskeletal problem, they need to see a physiotherapist. If they’re getting a new medication, maybe it would be best to see a pharmacist. 

I think we can do a much better job in reorganizing both the infrastructure of care and the way care is provided within a team.

3. What guidance and recommendations would you give someone considering a career as a family physician?

Do it! First of all, it’s not as bad as it currently looks. We know right now that well over 90% of new grads in family medicine choose to locum. They move around and try out different things. That’s one thing I would continue to recommend is to go to different communities and try out different practices, even different practice models and payment models.  

Look for the types of things that are going to support you in your practice and support you to be able to focus on being a family doctor. For example, look for a team-based care model and look for the business model that suits you. 

My biggest recommendation is that family medicine is a great career, and we are changing the practice environment. If you’re starting in med school now, or even in the middle of med school, when you come out of a family practice residency, it will be in a different place and I’m hoping, a much better place to work.

4. In what ways does the CFPC strive to provide ongoing support to family physicians throughout the changing landscape of primary care?

As the President of the college, I am the spokesperson and I have the opportunity to meet with federal ministers regularly and advocate for the changes addressed above. The CFPC is the only organization that is dedicated to family medicine and family physicians. There are other medical organizations, but they cover all specialties, not just the specialty of family medicine.

We’re dedicated, and we advocate specifically for the changes needed in the system to support family medicine. The CFPC is meeting and supporting our provincial chapters, meeting with their provincial governments and leaders with respect to that advocacy.

We’re supporting family physicians in continuing education. We create programs and support programs with the rapid expansion of knowledge and skills to ensure that family physicians keep up and are able to manage the complexity of care and the complexity of the system. The CFPC puts a lot of energy into creating, vetting and certifying resources for family physicians, supporting them in their daily practice.

We’re also providing resources and data on how to have a team-based care model and make it effective. We’re working on shifting the entire primary care system into this team-based model and the CFPC is supporting and advocating and building resources for that.

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