Procedures in ambulatory care. Which family physicians do what in southwestern Ontario?

Abstract

Objective: To determine how often family physicians perform 12 ambulatory care procedures and factors associated with procedure performance.

Design: Mailed, self-administered survey. The survey was conducted according to the Dillman Total Design method.

Setting: Family physicians' offices in London, Ont, and in surrounding communities.

Participants: A total of 395 family physicians practising within the London area were mailed surveys, 237 in London and 158 outside London. Response rates were 80.6% and 75.9%, respectively. Nonresponders did not differ significantly from responders in sex but included more solo practitioners.

Main outcome measures: Performance of ambulatory care procedures, sex, and practice characteristics of participant family physicians.

Results: For all responders, activities significantly associated with procedure performance were delivering babies, managing psychological problems, working emergency, and teaching. Mean total procedure scores ranged from 6.55 for managing psychological problems to 7.68 for working emergency. Sex-specific analysis showed that practice location and years in practice were significant factors for female but not for male family physicians. Mean total procedure scores for female physicians were 7.06 (outside London) and 4.74 (in London).

Conclusions: Factors associated with procedure performance for family physicians in and around London included delivering babies, working in emergency, managing psychological problems, and teaching. Practice location was a significant factor for only female family physicians; those practising outside London performed procedures more than their urban counterparts and at similar rates to male physicians.