Primary Care Physician Panel Size and Quality of Care: A Population-Based Study in Ontario, Canada

Simone Dahrouge; William Hogg; Jaime Younger; Elizabeth Muggah; Grant Russell; Richard H. Glazier

doi:10.1370/afm.1864

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Re: Primary Care Physician Panel Size and Quality of Care: A Population-Based Study in Ontario, Canada
Mark E. Unverzagt

Published on: 21 January 2016

Published on: (21 January 2016)
Page navigation anchor for Re: Primary Care Physician Panel Size and Quality of Care: A Population-Based Study in Ontario, Canada
Re: Primary Care Physician Panel Size and Quality of Care: A Population-Based Study in Ontario, Canada
Mark E. Unverzagt, Physician
I really enjoyed reading this article. In most parts of the United States, it would not be possible to do this type of research. Assignment of patients to a primary care panel in practices outside of a closed system is so arbitrary that one never knows what type of data the health plans use to evaluate us. Many patients are assigned to us that have never been seen in our practice. Yet "quality performance data" includes s...
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I really enjoyed reading this article. In most parts of the United States, it would not be possible to do this type of research. Assignment of patients to a primary care panel in practices outside of a closed system is so arbitrary that one never knows what type of data the health plans use to evaluate us. Many patients are assigned to us that have never been seen in our practice. Yet "quality performance data" includes such affiliations.
While these results are interesting, the next steps will be more so. In this study, I found it interesting that the providers with larger panel sizes were more often foreign trained and cared for a younger, poorer population with higher numbers of recent immigrants. Understanding those variables is intriguing. Furthermore, there was no delineation between or among the different practice types to see how that might affect the outcomes.
Understanding the personal and practice/system characteristics of physicians that are more efficient is where the rubber meets the road. What drives this kind of behavior? And what role do quality or performance measures play in this dynamic? Furthermore, do these analyses really help us understand what constitutes a more optimal delivery of primary care?
Competing interests: None declared
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Competing Interests: None declared.