Dr. Sarah Chritchley established her full-service longitudinal family practice in 2010. Prior, she experienced many areas of family medicine such as clinical work in a dialysis unit, surgical assists, team work at a community health centre and episodic care at walk-in clinics. She understands the challenges faced by family physicians in different environments and believes we need to collaborate to improve the system. Her heart lies in the patient-physician relationship that exists so uniquely in full-service community family practice. Most of all, Dr. Chritchley loves being a family doctor and feels privileged to do this important work, and appreciates the support of the FMPE and her group.
When did you first encounter FMPE?
I was introduced to FMPE in my residency program in Ottawa back in the ‘90s. I subsequently joined my first group out of residency when one of my friends suggested starting one. He became the facilitator and the group began meeting.
Creating this group was pivotal for me. When you start out in practice you are quite insecure about your medical knowledge. I think we all have a little bit of that imposter syndrome. We’re really concerned about making a mistake. Everybody wants to be perfect, but you don’t have that much experience. So by joining a group of peers you can effectively check in by asking simple questions, “What would you do?”; “Did I do the right thing?”; “What else could I have done?”. The groups are a safe environment to ask questions.
Did you continue on with your group work?
I moved from Ottawa in 2001, and when I came to Victoria, where I now live, I knew that I had to be in an FMPE group—that was very important to me. So I decided to take the facilitator training because that way I could get a group started. I reached out to a whole bunch of doctors I had recently met in the community, and we formed a group; and happy to say that group has been going strong ever since—it’s been something like twenty two years now.
It’s interesting because it certainly has evolved over the years. Now the group is quite varied: we have one doctor who’s retiring, several in mid-career, and one or two newer doctors in the group, because we try to add members whenever we can. But as the group evolves, the vast majority have stayed together. This is pretty typical amongst groups across the country.
What’s great is that over time you learn more. Conversations become even more robust; people are more comfortable expressing what they don’t know, because they are in a safe, non-judgemental environment. It’s about acknowledging medicine is a very difficult field and we’re all going to make mistakes.
Sometimes we disagree because our own experience has found something else to be true, but this leads to even deeper discussions. What I want to emphasize is that these are people you can trust—you see them on a monthly basis over many years and that connection is invaluable. It’s completely different to me than other types of CME. I mean, it’s fun to go to a conference, have people spoon-feed you information, and take it home. But this situation offers so much more—whether that be in person or virtually.
Facilitation is also really rewarding. I’m happy to be a resource to the group, especially when it comes to facilitating questions that people might be thinking but not asking. I also really enjoy interacting with FMPE staff who provide important support to the groups. If you email in a question about something your group would like to do differently or questions about the modules, a module developer or even a director will get right back to you. So they’re very responsive to questions and concerns.
Why did you subsequently decide to join the FMPE Board of Directors?
I actually saw a notice go out to all the facilitators in B.C., Alberta and Yukon to ask if any of us were interested in being on the Board of Directors. At that time the Executive Director of FMPE was Dr. Tom Elmslie, who I had met previously when I was a resident at the University of Ottawa—he was one of the professors there.
I can say that being a member of the Board of Directors was completely perspective-changing. For one, as a facilitator or a member in a group, you don’t realize the amount of work that goes into creating each module. How long it takes to make sure that the evidence is right. Becoming a Board member gave me access to behind the scenes, as it were.
I saw that not only is the information evidence based, but the way of providing the information to physicians is also evidence based. They’re doing research into what is the best way to help family doctors learn this information, retain it, and actually apply it into their practice. That research is constantly going on.
It was fascinating to learn more about the history of the organization. The fact that in the beginning no family doctors were meeting—this FMPE approach and methodology was revolutionary. The first meetings were in a basement and then slowly building modules and growing the membership from local to across the country with very little resources, but a whole lot of passion.
And then there are FMPE’s incredible staff who are all so invested in what they do. I think it speaks volumes that staff have remained part of the organization for twenty or thirty years, in some cases. Same goes for long-standing members.
It’s really a dynamic group of people spread out among many ages, and many years of experience and backgrounds. And even to see Dr. Jacquie Wakefield is still actively involved. Jacquie was one of the originals who helped get the organization off the ground.
FMPE also supports interns from McMaster, many of whom go on to become staff members. This supportive approach is wonderful for our younger members of the organization to gain a foothold in the industry and meaningfully contribute. It also allows a path towards greater diversity, in all its facets, for FMPE.
If somebody’s reading this article, maybe they are a residency student or in their first five years of practice, what would you tell them about FMPE?
I would encourage them to join a group as soon as they can, get as involved as they can, and try to stay with the group if possible throughout their journey as a physician. Your group evolves with you. There is a commitment by participants that no matter what, we meet every month. And it’s irreplaceable to your evolution in medical care.
When someone in the group has had a case that is really interesting or difficult, they are eager to share this to gain feedback and perspective. The lessons that members teach you from what they experienced is so important and extremely memorable. It’s also about humanizing the patient, talking about not just the disease but the person suffering from it. To go to your FMPE group and say, “Well, this is what I see. These have been the impacts on both the patient and their family”, is very powerful.
I think that everyone’s journey in their group differs. But it is our collective need to collaborate to improve the system, to serve our patients better, that drives us to keep learning. As my Dad (a retired oncologist) always says, “patients are our greatest teachers”.