Family physicians' responses to personal protective equipment shortages in four regions in Canada: a qualitative study

Maria Mathews¹, Dana Ryan², Lindsay Hedden³, Julia Lukewich⁴, Emily Gard Marshall⁵, Shabnam Asghari⁶, Amanda Lee Terry^{2

7}, Richard Buote⁵, Leslie Meredith², Lauren Moritz⁵, Sarah Spencer³, Judith B Brown², Erin Christian⁸, Thomas R Freeman², Paul S Gill², Shannon L Sibbald^{2

9}, Eric Wong^{2

10

11}

Affiliations

¹ Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 5C1, Canada. maria.mathews@schulich.uwo.ca.
² Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 5C1, Canada.
³ Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
⁴ Faculty of Nursing, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
⁵ Department of Family Medicine Primary Care Research Unit, Dalhousie University, 1465 Brenton Street, Suite 402, Halifax, NS, B3J 3T4, Canada.
⁶ Discipline of Family Medicine, Faculty of Medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
⁷ Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 5C1, Canada.
⁸ Nova Scotia Health, 78 Lovett Lake Ct, Halifax, NS, B3S 1B8, Canada.
⁹ Faculty of Health Sciences, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada.
¹⁰ Thames Valley Family Health Team, 1385 North Routledge Park, Unit 6, London, ON, N6H 5N5, Canada.
¹¹ St. Joseph's Health Care London, Family Medical Centre, PO Box 5777, Stn B, London, ON, N6A 4V2, Canada.

PMID: 36849904
PMCID: PMC9969942
DOI: 10.1186/s12875-022-01958-7

Family physicians' responses to personal protective equipment shortages in four regions in Canada: a qualitative study

Maria Mathews et al. BMC Prim Care. 2023.

. 2023 Feb 27;24(1):56.

doi: 10.1186/s12875-022-01958-7.

Authors

Affiliations

¹ Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 5C1, Canada. maria.mathews@schulich.uwo.ca.
² Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 5C1, Canada.
³ Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
⁴ Faculty of Nursing, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
⁵ Department of Family Medicine Primary Care Research Unit, Dalhousie University, 1465 Brenton Street, Suite 402, Halifax, NS, B3J 3T4, Canada.
⁶ Discipline of Family Medicine, Faculty of Medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
⁷ Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 5C1, Canada.
⁸ Nova Scotia Health, 78 Lovett Lake Ct, Halifax, NS, B3S 1B8, Canada.
⁹ Faculty of Health Sciences, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada.
¹⁰ Thames Valley Family Health Team, 1385 North Routledge Park, Unit 6, London, ON, N6H 5N5, Canada.
¹¹ St. Joseph's Health Care London, Family Medical Centre, PO Box 5777, Stn B, London, ON, N6A 4V2, Canada.

PMID: 36849904
PMCID: PMC9969942
DOI: 10.1186/s12875-022-01958-7

Abstract

Background: Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians' (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning.

Methods: As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis approach was employed to identify recurring themes. For the current study, we examined themes related to PPE.

Results: A total of 68 FPs were interviewed across the four regions. Four overarching themes were identified: 1) factors associated with good PPE access, 2) managing PPE shortages, 3) impact of PPE shortages on practice and providers, and 4) symbolism of PPE in primary care. There was a wide discrepancy in access to PPE both within and across regions, and integration with hospital or regional health authorities often resulted in better access than community-based practices. When PPE was limited, FPs described rationing and reusing these resources in an effort to conserve, which often resulted in anxiety and personal safety concerns. Many FPs expressed that PPE shortages had come to symbolize neglect and a lack of concern for the primary care sector in the pandemic response.

Conclusions: During the COVID-19 pandemic response, hospital-centric plans and a lack of prioritization for primary care led to shortages of PPE for family physicians. This study highlights the need to consider primary care in PPE conservation and allocation strategies and to examine the influence of the underlying organization of primary care on PPE distribution during the pandemic.

Keywords: COVID-19; Family physician; Pandemic response; Personal protective equipment; Policy planning; Primary care; Qualitative research.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

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Family physicians' responses to personal protective equipment shortages in four regions in Canada: a qualitative study

Affiliations

Family physicians' responses to personal protective equipment shortages in four regions in Canada: a qualitative study

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous