Practice patterns among early-career primary care physicians and workforce planning implications: a mixed methods study

There are more family doctors in Canada then ever. Yet, patients still have trouble finding a family doctor and getting an appointment when they need one. Changes in how much family doctors work and what services they provide (for example, choosing to practice with a clinical specialty, in a walk-in clinic, or providing care in hospital, rather than traditional family medicine), may help explain the gap between the number of doctors and patient access to primary care. It is widely speculated that new primary care doctors are practicing differently than previous generations. We know there have always been differences between doctors starting their careers and those who are already established, but we do not know if these differences are actually growing. This project will use information from qualitative interviews with doctors, surveys of doctors, and data routinely collected as part of health care delivery in British Columbia, Ontario, and Nova Scotia to achieve several related objectives. First, we will use survey data and interviews to explore plans for practice among doctors training in family medicine and the choices they make as they start out in practice. We want to understand what values and preferences, including the type work, lifestyle, and financial considerations, shape plans and choices. Second, we will use health care data to compare practice patterns among new and established doctors. We will determine if any changes over time are unique to the most recent generation of family doctors, or if there have been changes over time across all family doctors. Finally, we will examine how opportunities available to doctors in each province align with their preferences. We will reach out to doctors and policymakers to explore what other opportunities might be chosen, if available, and consider what policy changes may be needed to make sure that patients can access the services they need.