Pushing for more accountability: Trio of doctors propose governance shake-up at the CFPC

The College of Family Physicians of Canada (CFPC) is letting FPs down at a time when their specialty needs support the most. Or so says a trio of member doctors who are nudging the college towards change.“I don’t know if ‘debacle’ is too strong a word. Maybe it isn’t. They’ve had issue after issue,” said FP Dr. Greg Dubord about the CFPC. “We have a massive crisis in primary care. It just keeps getting worse all the time. You need a high functioning organization when you’ve got a crisis going on. And we don’t have that; we are so far from that.”Dr. Dubord is referring to trust issues between the college and its members. They stem from a 2025 CFPC proposal to tie annual fee increases to inflation, which members rejected, as they did a 2023 plan to increase residency from two to three years—the PGY3 plan. Some members feel there were broken promises around the CFPC’s commitment to review the PGY3 decision-making process and regularly release fulsome board minutes. Meanwhile, a survey conducted in 2024 found members gave it a -37 net promoter score—with +100 being perfect and 0 good. “Not great,” the CFPC admitted.Dr. Dubord, who is also an assistant professor at the University of Toronto, observed members successfully make governance changes at the Ontario Medical Association (OMA) last June. He reached out to two FPs who were involved in those efforts to launch a similar undertaking at the CFPC.This group has proposed six bylaw amendments that are being put to a vote at the October 28 annual members meeting. The three actually filed separately, submitting the exact same amendments using the same wording.Dr. Sohail Gandhi, an FP who practices in the Collingwood area and has served as president of the OMA, has been a part of this advocacy. As well, Gandhi’s blog justanoldcountrydoctor offers readers updates on the issues, including outlining the proposed bylaws.“I’ve always believed that the members, particularly with a physician organization, most of the time will get it right,” he said. “These kinds of organizations have a history of excluding people who can shake things up. There’s a tendency in bureaucracies towards inertia and keeping things the same.”FP Dr.Paul Conte, who practices in Kitchener and has served on the OMA’s board, including as chair, has also been involved.“We’re trying to get the CFPC to be more accountable to its membership; those that pay the dues. And we’re trying to get the CFPC to understand how increased accountability to the members leads to more member interest, more member participation and a more vibrant organization,” he said.The six bylaw amendments include: having members elect the board and president directly without a nomination committee screening candidates in advance; posting board and committee minutes to the member portal within 30 days; permitting members to vote electronically in advance on member proposals; accepting member proposals year-round; requiring the board to respond within 90 days to any passed member proposal with an implementation plan or a rejection that members can also vote on; publishing financials annually on spending around travel and hospitality, sponsors who give over $10,000, spending on the college’s continuing education program, consultant fees and legal fees.These changes are intended to get members more involved in the activities of the college and increase transparency and accountability.“You need crowdsourcing,” said Dr. Dubord. “You need to tap into the wisdom of the tens of thousands of family physicians who are out there in the field and find out what they think would make the system better.”The CFPC reached out to the three FPs in the summer regarding the amendments, offering to collaborate on them to ensure they “support the College’s governance framework.” The trio declined; Dr. Dubord replied that his amendments would stay the same and asked for clarity around which specific parts were not compliant with federal legislation, but did not receive a response to that question.The college is presenting the proposed bylaws alongside five alternative proposals, suggesting their versions will be more practical to implement plus they’ll be compliant with their other bylaws and the legislation that governs the organization. They say their versions preserve the intentions behind the original amendments. (The college suggests members simply reject the bylaw regarding accepting member proposals all year long.)The meeting will also include other business such as dealing with financials, appointing a public accountant, electing the board and making other bylaw amendments aimed at ensuring the college is in better compliance with non-profit laws.It’s a hefty amount of material for members to digest in advance of the meeting. It could be a lengthy and perhaps contentious one as the college and its members get their annual chance to discuss important matters and plan what’s next.For this group of FPs who feel there is a better way forward, there is hope for change in the right direction.Said Dr. Dubord: “I don’t know what is ideal. But I can tell you that what’s going on right now isn’t working very well.”

Pushing for more accountability: Trio of doctors propose governance shake-up at the CFPC

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