Should family physicians treat members of the same family?: NO.

In Canada, it has long been a given that physicians treat entire families. This notion is so deeply rooted in the culture of family medicine that it is part of the name of our discipline. The world in which we live has changed, however, and so have our patients and our discipline. It is high time that we asked ourselves whether a “family” practice is still a desirable practice. I will attempt to demonstrate that it is indeed a desirable practice, but with one condition: our patients must want and ask for this. In general, I think that they do want this. There are a few notable exceptions. The first that comes to mind is the physician’s area of expertise. Personally, I do not deliver babies nor do I provide follow-up care to patients who have just given birth. I have neither the expertise nor the interest. Another exception that comes to mind is confidentiality and conflict of interest. One example would be a patient who has consulted for screening for sexually transmitted infections because he has been unfaithful to his wife and he now wonders whether I would take his wife on as a patient. These are rare exceptions and they are not the point of this debate. This debate is about the principle of treating entire families and whether, in most cases, this practice is advisable.