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. 2022 Nov;68(11):836-846.
doi: 10.46747/cfp.6811836.

Family physician practice patterns during COVID-19 and future intentions: Cross-sectional survey in Ontario, Canada

Tara Kiran  1 , Ri Wang  2 , Curtis Handford  3 , Nadine Laraya  4 , Azza Eissa  5 , Pauline Pariser  6 , Rebecca Brown  7 , Cheryl Pedersen  8
Affiliations

Family physician practice patterns during COVID-19 and future intentions: Cross-sectional survey in Ontario, Canada

Tara Kiran et al. Can Fam Physician. 2022 Nov.

Abstract
in English, French

Objective: To determine the extent to which family physicians closed their doors altogether or for in-person visits during the pandemic, their future practice intentions, and related factors.

Design: Cross-sectional survey.

Setting: Six geographic areas in Toronto, Ont, aligned with Ontario Health Team regions.

Participants: Family doctors practising office-based, comprehensive family medicine.

Main outcome measures: Practice operations in January 2021, use of virtual care, and future plans.

Results: Of the 1016 (85.7%) individuals who responded to the survey, 99.7% (1001 of 1004) indicated their practices were open in January 2021, with 94.8% (928 of 979) seeing patients in person and 30.8% (264 of 856) providing in-person care to patients reporting COVID-19 symptoms. Respondents estimated spending 58.2% of clinical care time on telephone visits, 5.8% on video appointments, and 7.5% on e-mail or secure messaging. Among respondents, 17.5% (77 of 439) were planning to close their existing practices in the next 5 years. There were higher proportions of physicians who worked alone in clinics among those who did not see patients in person (27.6% no vs 12.4% yes, P<.05), among those who did not see symptomatic patients (15.6% no vs 6.5% yes, P<.001), and among those who planned to close their practices in the next 5 years (28.9% yes vs 13.9% no, P<.01).

Conclusion: Most family physicians in Toronto were open to in-person care in January 2021, but almost one-fifth were considering closing their practices in the next 5 years. Policy makers need to prepare for a growing family physician shortage and better understand factors that support recruitment and retention.

Objectif: Déterminer la mesure dans laquelle les médecins de famille avaient complètement fermé leurs cliniques ou encore fermé leurs portes aux visites en personne durant la pandémie, leurs intentions quant à la pratique future et les facteurs connexes.

Type d’étude: Une enquête transversale.

Contexte: Six régions géographiques à Toronto (Ontario) qui concordaient avec les régions des équipes Santé Ontario.

Participants: Des médecins de famille pratiquant la médecine familiale complète en cabinet.

Principaux paramètres à l’étude: Les activités de la pratique en janvier 2021, le recours aux soins virtuels et les projets pour l’avenir.

Résultats: Parmi les 1016 (85,7 %) personnes qui ont répondu à l’enquête, 99,7 % (1001 sur 1004) ont indiqué que leur clinique était ouverte en janvier 2021; 94,8 % (928 sur 979) voyaient des patients en personne et 30,8 % (264 sur 856) dispensaient des soins en personne aux patients ayant des symptômes de la COVID-19. Les répondants estimaient avoir consacré 58,2 % de leur temps de soins cliniques aux rendez-vous téléphoniques, 5,8 % aux rendez-vous par vidéo et 7,5 % à des courriels ou une messagerie sécurisée. Parmi les répondants, 17,5 % (77 sur 439) prévoyaient fermer leur pratique au cours des 5 prochaines années. Les médecins qui travaillaient seuls en clinique représentaient des proportions plus élevées parmi les médecins qui n’avaient pas vu de patients en personne (27,6 % non c. 12,4 % oui, p<,05), parmi ceux qui n’avaient pas vu de patients symptomatiques (15,6 % non c. 6,5 % oui, p<,001) et parmi ceux qui prévoyaient fermer leur pratique au cours des 5 prochaines années (28,9 % oui c. 13,9 % non, p<,01).

Conclusion: La plupart des médecins de famille à Toronto étaient réceptifs aux soins en personne en janvier 2021, mais près du cinquième de ces médecins de famille envisageaient la fermeture de leurs pratiques au cours des 5 prochaines années. Les décideurs doivent se préparer à une pénurie grandissante de médecins de famille et mieux comprendre les facteurs favorables au recrutement et à la rétention.

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Figures

Figure 1.
Figure 1.
Flowchart of family physician survey recruitment and survey formats used
Figure 2.
Figure 2.
Types of virtual care support that family physicians indicated were “very helpful” in providing primary care to patients (N=448)
See this image and copyright information in PMC

Comment in

  • Family medicine's stress test.
    Pimlott N. Pimlott N. Can Fam Physician. 2022 Nov;68(11):793. doi: 10.46747/cfp.6811793. Can Fam Physician. 2022. PMID: 36376034 Free PMC article. No abstract available.
  • Test de résistance de la médecine familiale.
    Pimlott N. Pimlott N. Can Fam Physician. 2022 Nov;68(11):794. doi: 10.46747/cfp.6811794. Can Fam Physician. 2022. PMID: 36376036 Free PMC article. French. No abstract available.

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