Family doctors want term 'family medicine' protected legally

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Family physicians are concerned that terminology associated with their profession — such as "family medicine" — could be misused by people who are not medical doctors, according to the results of an informal internal poll by the College of Family Physicians of Canada.

The CFPC, which represents about 38,000 physicians who practise family medicine, solicited feedback from its members in April and received approximately 4,400 responses.

The poll found 92 per cent of respondents support legally protecting such terms, and 89 per cent want the college to put its time and resources into doing so.

The college was prompted to investigate how widely that sentiment was shared after its executives were presented with a petition by some members who were concerned that certain terminology was being misused by some complementary health practitioners, such as naturopaths or people who work for "virtual medicine" apps.

Naturopathy enjoys popularity among people who seek an alternative to conventional medical care, but its critics say it is not supported by evidence-based science. Naturopathy is a combination of practices that predate modern medicine, such as homeopathy, acupuncture and traditional Chinese medicine, along with new treatments that are often not covered by provincial health plans, including intravenous vitamin therapy and nutrition counselling.

According to the Canadian Association of Naturopathic Doctors, naturopaths must complete a four-year, full-time program at an accredited institution. There are two such schools in Canada, both of which are private. The association says more than 2,400 naturopaths practise in Canada.

There are no consistent rules across the country about what naturopaths can call themselves.

In B.C., the naturopathic college stipulates they can only refer to themselves as a  "physician" if the word is preceded with "naturopathic" each time. The rules in Ontario prohibit use of the word "physician" by naturopaths at any time. The profession is not regulated in Quebec or Atlantic Canada. 

Meanwhile, the Canadian Association of Naturopathic Doctors has trademarked the slogan "Medically trained. Naturally focused," though it is now effectively illegal for a naturopath to say this in New Brunswick.

Dr. Michelle Cohen, a family physician in Brighton, Ont., says the call for CFPC to take action is "overwhelming." She is part of a grassroots group of family doctors across Canada that is active on social media and has filed complaints against those who they feel misrepresent themselves as medical doctors.

"I do feel like [the CFPC has] been dragging their heels just a little bit. But I'm hopeful that with their understanding that this is important to the membership, that they're going to push forward on it," she said.

Cohen and other members of the group are credited with a complaint that led to a New Brunswick court ruling against a group of naturopaths who posted advertisements using such words as "family medicine practice," "medical centre," "family doctor" and "medically trained," among other descriptions.

The New Brunswick College of Physicians and Surgeons was granted an injunction in the province's Superior Court to stop the naturopaths there from using the terms. Naturopathy is not a regulated profession in New Brunswick.

In his ruling, Justice Hugh McLellan said naturopaths "are in some ways close and similar to the work of all sorts of other people, like wellness coaches or fitness gurus or health consultants … But they are not practising medicine."

Nicole Basque, a naturopath in Moncton, N.B., was among those ordered to stop using "family medicine" to describe her practice. At the time, she defended her use of the term by saying it referred to the fact that she treats people of all ages, "from a newborn to an elderly person," not that she is "a general practitioner or an MD."

CFPC executive director Dr. Francine Lemire acknowledges that co-ordinating a common set of rules protecting the terms associated with family medicine in different provincial and territorial jurisdictions will be challenging.

But what defines a family physician is not open to interpretation, she said. "It's a general physician who's got an MD degree and got defined postgraduate training in the discipline of family medicine."

The CFPC is consulting all the provincial and territorial colleges of physicians and surgeons and aims to come up with a set of recommendations in 12 to 18 months, Lemire said.

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