Dr. Fiona Duncan on why you should get involved with the Division, and how it works to affect change in our field. Are you interested in joining a committee? Find current opportunities here.
The Vancouver Division of Family Practice operates at the intersection of policy, operations, and frontline care. As Physician Lead, Dr. Fiona Duncan plays a unique role within that landscape—one grounded in nearly 25 years of experience as a practising family physician in Vancouver.
Her perspective is shaped not just by leadership, but by day-to-day clinical reality.
“My role as physician lead… is really to bring the physician voice to the conversations that we’re having,” she explains. “To help… complement and balance out the operational lens.”
Why the Division Matters
At its core, the Division exists to create space for physicians to contribute meaningfully to the healthcare system, outside of the political sphere.
“[The Division was] created [as] a non-political organization to bring forth the voice of doctors,” Fiona explains. She describes this as a form of “little ‘a’ advocacy”, not adversarial, but collaborative and focused on improving care.
This positioning allows the Division to act as a bridge between independent physicians and system partners like the health authority. “Divisions… create a space where doctors… are able to come together and bring their voice to the healthcare system,” she says.
Over time, that model has enabled innovation rooted in frontline experience. “When you look at our last 15 years, you really do see… innovative ways that we were able to bring things forward… from grassroots, from the physicians on the ground.”
A Role Designed for Balance
Unlike other leadership roles within the Division, the Physician Lead position was intentionally created as an operational—not governance—role. This distinction allows for a more direct and continuous connection between leadership decisions and the realities of community-based care.
“We wanted to have a senior community physician member… with their feet firmly planted in the operational role,” Fiona says. “To bring that lens.”
Sitting on the executive team, she works alongside leadership who bring operational, organizational, and external perspectives—ensuring that decisions reflect both system priorities and the lived experience of physicians on the ground.
Impact Over Time
Looking back, Fiona highlights several areas where the Division has had meaningful impact.
One of the most significant is the Division’s Patient Attachment Initiative, which attaches patients with primary care providers and has attached more than forty-five thousand patients since 2015. What began as a local project associated with recruitment and retention has since evolved into a structured, multi-faceted program that now plays a central role in the broader system.
“It didn’t just influence work that was already happening,” she says. “It created its own program and stream.”
Clinic support is another cornerstone. By building a deep understanding of how community clinics operate, the Division has been able to both advocate for needed resources and provide direct, practical support.
“Just literally getting in there and helping clinics stay afloat… has done a tremendous job of keeping doctors working in Vancouver,” Fiona notes.
Long-standing collaborative work in areas like long-term care, mental health and substance use, and maternity care have also established the Division as a trusted partner. These relationships, often built quietly over time, continue to shape care delivery across the system.
Looking Ahead: System Change and Stability
As the healthcare landscape continues to evolve, Fiona sees Primary Care Networks (PCNs) as a major focus.
“It’s massive system change,” she says. “And it’s bumpy… like building the airplane while we’re trying to fly it.”
Despite the challenges, she remains optimistic about the direction. “We really are getting there,” she adds, pointing to the continued emphasis on maintaining a strong physician voice and expanding opportunities for patient and community input.
Alongside system-level change, she is equally focused on sustaining physician-run clinics as the foundation of community-based care.
“There is something special about that… that we want to maintain within our community,” she says. Supporting clinics to remain viable in a challenging economic and workforce environment remains a key priority.
Opportunities to Get Involved
For members, the Division offers multiple ways to engage—whether at a high level or in more hands-on roles.
“There’s opportunity to get as involved or remain as distanced as you want to,” Fiona explains. From staying informed through communications like Fast Facts, to attending events, joining committees, or even running for the board, the structure is intentionally flexible. Importantly, there is a clear separation between governance and operational work—allowing physicians to choose how they want to contribute.
A System Built on Collaboration
When asked about specific programs to highlight, Fiona draws attention to the more recent initiatives in physician wellness, environmental health, and ongoing efforts around equity and inclusion. “I’m really proud of some of the work we’ve done lately,” she says, and points to the broader strength of the organization as it has evolved over time.
Rather than focusing on a single priority, moving forward, her perspective reflects confidence in the Division’s overall direction—and its ability to evolve alongside the system it supports.
That sense of balance—between progress and perspective—captures the essence of her role: ensuring that as the system changes, the physician voice remains present, grounded, and central to the conversation.