ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2022
Changes over time in patient visits and continuity of care among graduating cohorts of family physicians in 4 Canadian provinces.
Abstract read
In one paragraph
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed.
- More Indirect Patient Care Activities per Visit: 11-Year Analysis of Family Physician Electronic Health Records in Canada.Annals of family medicine · 2026Article
- Continuity of Primary Care in Community Health Centers.Annals of family medicine · 2026Article
- Access to primary care for people with chronic pain: a lived/living experience-informed mixed-methods study protocol.BMJ open · 2026Article
- Article
- Article
- Changes in Family Physicians Over Time in Alberta, Canada: A 16-Year Population-Based Cohort Study.Annals of family medicine · 2025Article
- An assessment of family medicine residents' and early career physicians' perceptions of their training: a survey from a single Canadian university.Canadian medical education journal · 2025Article
- Primary care physician characteristics associated with becoming opioid agonist treatment prescribers in British Columbia: a retrospective case-control study.Harm reduction journal · 2025Article
- Trends colliding: Aging comprehensive family physicians and the growing complexity of their patients.Canadian family physician Medecin de famille canadien · 2025Article
- Changing primary care capacity in Canada: protocol for a cross-provincial mixed methods study.BMJ open · 2025Article
- Article
- Supporting future and current rural physicians.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Early career family physician perspectives on their residency experience and practice choices in Canada: a qualitative study.Canadian medical education journal · 2024Article
- "Recycling" doctors might help address family physician shortages.Canadian family physician Medecin de famille canadien · 2024Article
- Characteristics of walk-in clinic physicians and patients in Ontario: Cross-sectional study.Canadian family physician Medecin de famille canadien · 2024Article
- Demographic and temporal trends in mental health and substance use services provided by primary care physicians in British Columbia, Canada.BMC primary care · 2024Article
- Chronic pain management in primary care: Using population-based data to examine family physician practice patterns.Canadian family physician Medecin de famille canadien · 2024Article
- Advice to future family physicians: findings from qualitative interviews with family medicine residents and early-career family physicians.BMC medical education · 2024Article
- Primary care quality for older adults: Practice-based quality measures derived from a RAND/UCLA appropriateness method study.PloS one · 2024Review
- Understanding and addressing changing administrative workload in primary care in Canada: protocol for a mixed-method study.BMJ open · 2023Article
Corrections and comments
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Authors and funding
20 authors.
David RudolerFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Sandra PetersonFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
David StockFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont. david.rudoler@ontariotechu.ca.
Carole TaylorFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Drew WiltonFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Doug BlackieFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Fred BurgeFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Richard H GlazierFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Laurie GoldsmithFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Agnes GrudniewiczFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Lindsay HeddenFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Margaret JamiesonFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Alan KatzFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Adrian MacKenzieFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Emily MarshallFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Rita McCrackenFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Kim McGrailFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Ian ScottFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Sabrina T WongFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
M Ruth LavergneFaculty of Health Sciences (Rudoler), Ontario Tech University, Oshawa, Ont.; Ontario Shores Centre for Mental Health Sciences (Rudoler), Whitby, Ont.; Centre for Health Services and Policy Research (Peterson, McGrail, Wong), The University of British Columbia, Vancouver, BC; Department of Community Health and Epidemiology (Stock, MacKenzie), Dalhousie University, Halifax, NS; Manitoba Centre for Health Policy (Taylor), University of Manitoba, Winnipeg, Man.; Institute for Clinical Evaluative Sciences (Wilton, Glazier), Toronto, Ont.; School of Leadership Studies (Blackie), Royal Roads University, Victoria, BC; Department of Family Medicine (Burge, Lavergne), Dalhousie University, Halifax, NS; St. Michael's Hospital (Glazier), Toronto, Ont.; Faculty of Health Sciences (Goldsmith, Hedden), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Telfer School of Management (Grudniewicz), University of Ottawa, Ottawa, Ont.; Institute of Health Policy Management and Evaluation (Jamieson), University of Toronto, Toronto, Ont.; Departments of Family Medicine (Katz) and Community Health Sciences (Katz), Winnipeg, Man.; Nova Scotia Health Authority (MacKenzie, Marshall), Halifax, NS; Department of Family Medicine (Marshall), Primary Care Research Unit, Dalhousie University, Halifax, NS; Department of Family Practice (McCracken, Scott), and Centre for Health Education Scholarship (Scott), and School of Nursing (Wong), The University of British Columbia, Vancouver, BC; National Institute of Nursing Research (Wong), Bethesda, Md.; Tier II Primary Care (Lavergne), Canada Research Chairs Program, Ottawa, Ont.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLack of patient access to family physicians in Canada is a concern. The role of recent physician graduates in this problem of supply of primary care services has not been established. We sought to establish whether career stage or graduation cohort were related to family physician practice volume and continuity of care over time.
methodsWe conducted a retrospective cohort study of family physician practice from 1997/98 to 2017/18. We collected administrative health and physician claims data in British Columbia, Manitoba, Ontario and Nova Scotia. We included all physicians who registered with their respective provincial regulatory colleges as having a medical specialty of family practice or who had billed the provincial health insurance system for patient care as family physicians, or both. We used regression models to isolate the effects of 3-year categories of years in practice (at all career stages), time period and cohort on patient contacts and physician-level continuity of care.
resultsBetween 1997/98 and 2017/18, the median number of patient contacts per provider per year fell by between 515 and 1736 contacts in the 4 provinces examined. Median contacts peaked at 27-29 years in practice in all provinces, and median physician-level continuity of care increased until 30 or more years in practice. We found no association between graduation cohort and patient contacts or physician-level continuity of care.
interpretationRecent cohorts of family physicians practise similarly to their predecessors in terms of practice volumes and continuity of care. Because family physicians of all career stages showed declining patient contacts, we suggest that system-wide solutions to recent challenges in the accessibility of primary care in Canada are needed.
Indexed as
Family PracticePhysicians, FamilyContinuity of Patient CareHumansOntarioRetrospective Studies
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