Practice patterns among early-career primary care (ECPC) physicians and workforce planning implications: protocol for a mixed methods study
Richard J Gibson,
Tara Sampalli,
Tara Kiran,
Richard H Glazier,
Agnes Grudniewicz,
Kimberlyn McGrail,
David Snadden,
Ian Scott,
M Ruth Lavergne,
Laurie J Goldsmith,
David Rudoler,
Emily Gard Marshall,
Megan Ahuja,
Doug Blackie,
Fred Burge,
Steve Hawrylyshyn,
Lindsay Hedden,
Jacalynne Hernandez-Lee,
Kathleen Horrey,
Mike Joyce,
Adrian MacKenzie,
Maria Mathews,
Rita McCracken,
Madeleine McKay,
Charmaine McPherson,
Goldis Mitra,
Gail Tomblin Murphy,
Sabrina T Wong
Affiliations
Richard J Gibson
7 Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Tara Sampalli
6 Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Tara Kiran
9 Department of Family and Community Medicine, St. Michael’s Hospital and University of Toronto, Toronto, Ontario, Canada
Richard H Glazier
9 Department of Family and Community Medicine, St. Michael’s Hospital and University of Toronto, Toronto, Ontario, Canada
Agnes Grudniewicz
University of Ottawa Telfer School of Management, Ottawa, Ontario, Canada
Kimberlyn McGrail
3 Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, British Columbia, Canada
David Snadden
Family Practice, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
Ian Scott
1 School of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia
M Ruth Lavergne
1 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
Laurie J Goldsmith
1 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
David Rudoler
Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
Emily Gard Marshall
Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Megan Ahuja
5 Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
Doug Blackie
6 School of Leadership Studies, Royal Roads University, Victoria, British Columbia, Canada
Fred Burge
Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Steve Hawrylyshyn
10 First Five Years group, College of Family Physicians of Canada, Toronto, Ontario, Canada
Lindsay Hedden
Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
Jacalynne Hernandez-Lee
4 Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Kathleen Horrey
4 Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Mike Joyce
11 Nova Scotia Department of Health and Wellness, Halifax, Nova Scotia, Canada
Adrian MacKenzie
12 Department of Community Health and Epidemiology and WHO/PAHO Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Nova Scotia, Canada
Maria Mathews
Department of Family Medicine, University of Western Ontario, London, Ontario, Canada
Rita McCracken
Department of Family Medicine, Providence Health Care, Vancouver, British Columbia, Canada
Madeleine McKay
Doctors Nova Scotia, Dartmouth, Nova Scotia, Canada
Charmaine McPherson
Independent Researcher, Halifax, Nova Scotia, Canada
Goldis Mitra
14 Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Gail Tomblin Murphy
12 Department of Community Health and Epidemiology and WHO/PAHO Collaborating Centre on Health Workforce Planning and Research, Dalhousie University, Halifax, Nova Scotia, Canada
Sabrina T Wong
14 Centre for Health Services and Policy Research and School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
Introduction Canadians report persistent problems accessing primary care despite an increasing per-capita supply of primary care physicians (PCPs). There is speculation that PCPs, especially those early in their careers, may now be working less and/or choosing to practice in focused clinical areas rather than comprehensive family medicine, but little evidence to support or refute this. The goal of this study is to inform primary care planning by: (1) identifying values and preferences shaping the practice intentions and choices of family medicine residents and early career PCPs, (2) comparing practice patterns of early-career and established PCPs to determine if changes over time reflect cohort effects (attributes unique to the most recent cohort of PCPs) or period effects (changes over time across all PCPs) and (3) integrating findings to understand the dynamics among practice intentions, practice choices and practice patterns and to identify policy implications.Methods and analysis We plan a mixed-methods study in the Canadian provinces of British Columbia, Ontario and Nova Scotia. We will conduct semi-structured in-depth interviews with family medicine residents and early-career PCPs and analyse survey data collected by the College of Family Physicians of Canada. We will also analyse linked administrative health data within each province. Mixed methods integration both within the study and as an end-of-study step will inform how practice intentions, choices and patterns are interrelated and inform policy recommendations.Ethics and dissemination This study was approved by the Simon Fraser University Research Ethics Board with harmonised approval from partner institutions. This study will produce a framework to understand practice choices, new measures for comparing practice patterns across jurisdictions and information necessary for planners to ensure adequate provider supply and patient access to primary care.
