Emergency docs or family physicians?

I am concerned that Benjamin Chan's research letter¹ dealing with the practice patterns of physicians with emergency medicine certification (CCFP [EM]) from the College of Family Physicians of Canada is based on the assumption that family medicine is a discipline defined by setting. Chan gives the impression that family medicine cannot be practised anywhere but within the confines of a clinic with strictly scheduled patient visits. The notion that family physicians hang up their family medicine knowledge, skill set and principles at the door when they enter an emergency department is at best naive.

In 1980 the College recognized that emergency medicine is a core part of family medicine and that a formal training and certification program should be provided to those wishing to practise both family medicine and emergency medicine or full-time emergency medicine.² Indeed, the considerable overlap between these disciplines makes clear the need for physicians certified in both. Through its residency and certification programs in emergency medicine across the country the College has done an outstanding job in fulfilling its mandate to “provide family physicians the opportunity to bring enhanced skills in emergency medicine to their communities.”³ Graduates of CCFP(EM) programs certainly use their family medicine background to provide high-quality medical care in emergency departments and other practice settings. Thus I strongly disagree with Chan's conclusion that his study demonstrates “an incongruity between the CCFP(EM) program's objective and the practice choices of its graduates.”

Philip Yoon Emergency Medicine Residency Program Director University of Alberta Edmonton, Alta.