My thanks once again to Dr. Greg Dubord (pictured inset) agreeing to post this on my site, (and doing most of the writing). Dr. Dubord is the founder of CBT Canada (www.cbt.ca) and a leading advocate of medical CBT. He completed his training under CBT’s Founder Dr. Aaron T. Beck and was the first Canadian Fellow of the Beck Institute. He has provided medical CBT workshops at many Family Medicine Forums. This blog originally appeared in the Medical Post.
Only 25% of CFPC members believe their fees are worth it.
That devastating verdict emerged from the College of Family Physicians of Canada’s own 2022 member satisfaction survey—unfortunately the last one they’ve published.
When three-quarters of your captive membership says they’re not getting value for money, you’d expect urgent reform and rigorous tracking of improvement. Instead, the CFPC did something remarkable: they stopped asking.
The survey, published by the CFPC’s own CEO Dr. Francine Lemire and executive director Eric Mang in Canadian Family Physician, contained another brutal statistic: Only 39% felt the CFPC was “listening to the opinions and needs of members.” More than 3,000 respondents delivered this indictment of their own professional organization—then watched the CFPC go silent on member satisfaction for three straight years.
Twenty-five percent is not a satisfaction score—it’s a vote of no confidence. In any other context, that number would trigger not just immediate crisis response, but deep organizational commitment to demonstrable change. A product with 25% customer satisfaction gets pulled from shelves. A restaurant with 25% customer approval likely ends up closing. A professional association with 25% approval hemorrhages members unless, of course, membership is mandatory.
When three-quarters of your customers—especially mandatory, captive customers who can’t leave—believe they’re not getting value for money, that’s not a minor problem requiring tweaks. That’s an existential crisis for the CFPC demanding comprehensive reform and continuous monitoring to track whether changes are working. Management guru Peter Drucker put it bluntly: “You can’t manage what you don’t measure.”
The CFPC instead chose this two-part treatment:
- stop measuring whether members think fees are worth it; and
- ask for more money. No survey in 2023—but a 7% dues increase proposal that 83.86% rejected. No survey in 2024. No survey in 2025—but another fee increase attempt, also rejected.
Imagine asking your boss for a raise while refusing to do your performance review. That’s essentially what the CFPC keeps doing.
This pattern becomes more revealing when you consider the CFPC’s demonstrated survey capabilities. During 2020 to 2022, the College conducted and published multiple iterations of COVID-19 impact surveys—2020, 2021 and June 2022—each with detailed, comprehensive reports and full datasets publicly available. These surveys served important functions, documenting physician challenges and supporting advocacy with government and policymakers.
The CFPC clearly has the infrastructure and expertise for longitudinal research. Yet member satisfaction—the metric showing only 25% believe fees are worth it—gets measured once, summarized briefly, then abandoned. When surveys document external challenges, members receive full transparency and accountability.
Although the CFPC’s 25% rating was horrible, it’s almost certainly a lot worse now. That survey was conducted before the PGY-3 controversy, and before the governance crisis that prompted our ten reform motions.
This brings us to one of our ten governance reforms for the 2026 AGM: Member satisfaction survey transparency. This motion would require annual CFPC member satisfaction surveys with published methodology, response rates and complete results (not curated summaries).
Healthy organizations that genuinely serve their members practice what the Japanese call kaizen—continuous improvement through regular measurement. When Toyota faced acceleration problems, they didn’t just stonewall—they analyzed data, implemented fixes, and reported progress transparently to regulators.
The CFPC has a rather unique accountability problem: membership is mandatory for most, and the dissatisfied can’t leave. Captive dues payers are left to brux in high frustration while wondering if anything will change. Economists call this “moral hazard.” When an organization is insulated from the consequences of poor performance, accountability diminishes. This structural accountability gap—and potential solutions—will be explored in detail in upcoming articles in this series.
Our transparency motion is straightforward: the CFPC will be required to measure member satisfaction annually, publish complete results and let members judge whether their mandatory fees produce acceptable value. If the CFPC is delivering excellence, the data will prove it, and they will have every right to feel proud of it. However, if they’re failing, members deserve to know—with implications for the legitimacy of dues.
Our earnest hope is that this upcoming year we’ll see a highly member-responsive CFPC make genuine changes that demonstrably impact member satisfaction, and they’ll proudly make that public.
justanoldcountrydoctor 