Canada | More and more family doctors are offering specialized care

The proportion of family doctors who primarily provide services outside of primary care is increasing from year to year. They offer more specialized care, according to a report released Tuesday by the Canadian Institute for Health Information (CIHI).

Based on analysis of 2021 physician payment data, 28% of Canadian primary care physicians primarily provide specialty care such as emergency medicine, psychiatry and general surgery. “They are therefore moving away from the activities traditionally associated with their role,” said an ICIS press release.

The institute gives the example of a family doctor with a practice profile in general surgery who, while remaining identified as such with his provincial college, could provide services normally billed by general surgeons, such as minor surgical procedures.

This is not a new phenomenon, emphasizes Chantal Couris, manager of health workforce, data methods and tools at CIHI.

The number of general practitioners providing services other than primary care increased from 24.8% in 2013 to 25.7% in 2019. This percentage continued to increase from 2019 to 2022, where it rose from 25.7% to 28 .3%. These statistics exclude Quebec, the Northwest Territories and Nunavut.

In an interview, MMe Couris stated that CIHI does not currently have the data for these regions. However, she believes this upward trend likely applies to Quebec as well.

“It's an extrapolation, but we have little reason to believe it is different,” she said. Things are different for the Northwest Territories. These are places where care is organized somewhat differently because they are far from large urban centers. However, in Quebec it is very likely that the data is similar to what has been observed elsewhere in the country, but has yet to be confirmed. »

In addition, the report shows that the five-year growth rate in the number of family medicine physicians has declined, from 12.9% between 2012 and 2016 to 7.7% between 2017 and 2021, and that the number of unfilled places in family medicine residency programs has increased overall Country.

“Every year there are more family doctors than the previous year,” explains M.Me Run. However, what we are seeing is that the rate at which these primary care physicians are growing is decreasing over time. »

Several factors may explain the evolution of primary care practices over the past decade. CIHI, for example, emphasizes that primary care is more likely to be the result of interdisciplinary collaboration.

Patients can actually consult other healthcare professionals such as nurses and pharmacists to access primary care.

MMe Couris said this type of shift is being seen in health care policy, but that the data in the report doesn't exactly explain why primary care physicians are increasingly practicing specialized care. “We see these changes over time. In order to understand the causes of these changes, a little more dialogue with the partners is required,” she comments.

MMe Couris points out that depending on how care is organized on both sides of the country, we should consider whether other health professionals are compensating for the fact that doctors are moving on to other activities.

She says more analysis is needed to answer these questions and understand what the best solutions are.

The Canadian Press health content is funded through a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for editorial selection.

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