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Research ArticleResearch Briefs

Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians

M. Ruth Lavergne, David Rudoler, Sandra Peterson, David Stock, Carole Taylor, Andrew S. Wilton, Sabrina T. Wong, Ian Scott, Kimberlyn M. McGrail, Rita McCracken, Emily G. Marshall, Adrian MacKenzie, Alan Katz, Margaret Jamieson, Lindsay Hedden, Agnes Grudniewicz, Laurie J. Goldsmith, Richard H. Glazier, Fred Burge and Doug Blackie
The Annals of Family Medicine March 2023, 21 (2) 151-156; DOI: https://doi.org/10.1370/afm.2945
M. Ruth Lavergne
Dalhousie University, Department of Family Medicine, Halifax, Nova Scotia, Canada (M. R. L., F. B.)
Canada Research Chairs Program, Tier II Primary Care, Ottawa, Ontario, Canada (M. R. L.)
MSc, PhD
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  • For correspondence: ruth.lavergne@dal.ca
David Rudoler
Ontario Tech University, Faculty of Health Sciences, Oshawa, Ontario, Canada (D. R.)
Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada (D. R.)
MPPAL, PhD
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Sandra Peterson
The University of British Columbia, Centre for Health Services and Policy Research, Vancouver, British Columbia, Canada (S. P., S. T. W., K. M. M.)
MSc
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David Stock
Dalhousie University, Department of Community Health and Epidemiology, Halifax, Nova Scotia, Canada (D. S., A. M.)
MSc, PhD
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Carole Taylor
University of Manitoba, Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada (C. T.)
MSc
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Andrew S. Wilton
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (A. S. W., R. H. G.)
MSc
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Sabrina T. Wong
The University of British Columbia, Centre for Health Services and Policy Research, Vancouver, British Columbia, Canada (S. P., S. T. W., K. M. M.)
National Institute of Nursing Research, Division of Intramural Research (this work was completed while at the University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada) (S. T. W.)
RN, PhD
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Ian Scott
The University of British Columbia, Department of Family Practice, Vancouver, British Columbia, Canada (I. S., R. M.)
The University of British Columbia, Centre for Health Education Scholarship, Vancouver, British Columbia, Canada (I. S.)
MSc, MD
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Kimberlyn M. McGrail
The University of British Columbia, Centre for Health Services and Policy Research, Vancouver, British Columbia, Canada (S. P., S. T. W., K. M. M.)
MPH, PhD
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Rita McCracken
The University of British Columbia, Department of Family Practice, Vancouver, British Columbia, Canada (I. S., R. M.)
MD, PhD
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Emily G. Marshall
Nova Scotia Health Authority, Halifax, Nova Scotia, Canada (E. G. M., A. M.)
Dalhousie University, Primary Care Research Unit, Department of Family Medicine, Halifax, Nova Scotia, Canada (E. G. M.)
MSc, PhD
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Adrian MacKenzie
Dalhousie University, Department of Community Health and Epidemiology, Halifax, Nova Scotia, Canada (D. S., A. M.)
Nova Scotia Health Authority, Halifax, Nova Scotia, Canada (E. G. M., A. M.)
PhD
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Alan Katz
University of Manitoba, Department of Family Medicine, Winnipeg, Manitoba, Canada (A.K.)
University of Manitoba, Department of Community Health Sciences, Winnipeg, Manitoba, Canada (A. K.)
MBChB, MSc
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Margaret Jamieson
University of Toronto, Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada (M. J., R. H. G.)
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Lindsay Hedden
Simon Fraser University, Faculty of Health Sciences, Burnaby, British Columbia, Canada (L. H., L. J. G.)
MSc, PhD
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Agnes Grudniewicz
University of Ottawa, Telfer School of Management, Ottawa, Ontario, Canada (A. G.)
PhD
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Laurie J. Goldsmith
Simon Fraser University, Faculty of Health Sciences, Burnaby, British Columbia, Canada (L. H., L. J. G.)
1GoldQual Consulting, Ontario, Canada (L. J. G.)
MSc, PhD
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Richard H. Glazier
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (A. S. W., R. H. G.)
University of Toronto, Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada (M. J., R. H. G.)
St Michael’s Hospital, Toronto, Ontario, Canada (R. H. G.)
University of Toronto, Department of Family and Community Medicine, Toronto, Ontario, Canada (R. H. G.)
MPH, MD
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Fred Burge
Dalhousie University, Department of Family Medicine, Halifax, Nova Scotia, Canada (M. R. L., F. B.)
MSc, MD
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Doug Blackie
Royal Roads University, School of Leadership Studies, Victoria, British Columbia, Canada (D. B.)
Doug Blackie Consulting, Inc, Edmonton, Alberta, Canada (D. B.).
MPA
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  • RE: Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians
    Jeta Hadjihamza and Lorraine S Wallace
    Published on: 03 January 2024
  • RE: Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians
    Jeta Hadjihamza and Lorraine S Wallace
    Published on: 18 November 2023
  • Published on: (3 January 2024)
    Page navigation anchor for RE: Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians
    RE: Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians
    • Jeta Hadjihamza, Medical Student, SS Cyril and Methodius University—Faculty of Medicine
    • Other Contributors:
      • Lorraine S Wallace, Associate Professor—College of Medicine

    This study presents a thought-provoking examination of the evolving family physician practice landscape in Canada, which prompts several pertinent questions and avenues for further research. One question that arises from the study's findings pertains to factors contributing to the observed decline in comprehensiveness. While the study addresses years in practice as a possible variable, it would be intriguing to explore whether declines are correlated with increased number of patients under a physician's care and/or the age distribution of their patients. A more detailed understanding of these contributing factors could help create strategies for optimizing care delivery in the future.

    Furthermore, I am curious about the historical context of comprehensiveness in family physician practice. Have previous studies compared eras such as the 1970s with the periods examined in this study (1999-2000 and 2017-2018)? Such a historical perspective could shed light on the trajectory of comprehensiveness in primary care over several decades and provide insights into whether decreases have been a continuous trend or marked by either short- or long-term variations.

    Exploration of potential temporal patterns is also an intriguing area for further investigation. Are there indications that the decrease in comprehensiveness has been accelerating in recent years, potentially indicating a worsening trend? Conversely, have there been periods of improvement or stability a...

    Show More

    This study presents a thought-provoking examination of the evolving family physician practice landscape in Canada, which prompts several pertinent questions and avenues for further research. One question that arises from the study's findings pertains to factors contributing to the observed decline in comprehensiveness. While the study addresses years in practice as a possible variable, it would be intriguing to explore whether declines are correlated with increased number of patients under a physician's care and/or the age distribution of their patients. A more detailed understanding of these contributing factors could help create strategies for optimizing care delivery in the future.

    Furthermore, I am curious about the historical context of comprehensiveness in family physician practice. Have previous studies compared eras such as the 1970s with the periods examined in this study (1999-2000 and 2017-2018)? Such a historical perspective could shed light on the trajectory of comprehensiveness in primary care over several decades and provide insights into whether decreases have been a continuous trend or marked by either short- or long-term variations.

    Exploration of potential temporal patterns is also an intriguing area for further investigation. Are there indications that the decrease in comprehensiveness has been accelerating in recent years, potentially indicating a worsening trend? Conversely, have there been periods of improvement or stability amidst the broader decline? Understanding these patterns could guide more targeted interventions and/or policy responses.

    In conclusion, the article by Lavergne and colleagues offers a valuable foundation for comprehending the dynamics of family physician practice comprehensiveness in Canada. The questions raised here highlight the potential for further research to provide a more nuanced and holistic view of this complex issue. I look forward to the prospect of additional studies that delve deeper into these questions, ultimately contributing to the enhancement of primary care practices.

    Show Less
    Competing Interests: None declared.
  • Published on: (18 November 2023)
    Page navigation anchor for RE: Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians
    RE: Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians
    • Jeta Hadjihamza, Medical Student, SS Cyril and Methodius University—Faculty of Medicine
    • Other Contributors:
      • Lorraine S Wallace, Associate Professor—College of Medicine

    This study presents a thought-provoking examination of the evolving family physician practice landscape in Canada, which prompts several pertinent questions and avenues for further research. One question that arises from the study's findings pertains to factors contributing to the observed decline in comprehensiveness. While the study addresses years in practice as a possible variable, it would be intriguing to explore whether declines are correlated with increased number of patients under a physician's care and/or the age distribution of their patients. A more detailed understanding of these contributing factors could help create strategies for optimizing care delivery in the future.

    Furthermore, I am curious about the historical context of comprehensiveness in family physician practice. Have previous studies compared eras such as the 1970s with the periods examined in this study (1999-2000 and 2017-2018)? Such a historical perspective could shed light on the trajectory of comprehensiveness in primary care over several decades and provide insights into whether decreases have been a continuous trend or marked by either short- or long-term variations.

    Exploration of potential temporal patterns is also an intriguing area for further investigation. Are there indications that the decrease in comprehensiveness has been accelerating in recent years, potentially indicating a worsening trend? Conversely, have there been periods of improvement or stability a...

    Show More

    This study presents a thought-provoking examination of the evolving family physician practice landscape in Canada, which prompts several pertinent questions and avenues for further research. One question that arises from the study's findings pertains to factors contributing to the observed decline in comprehensiveness. While the study addresses years in practice as a possible variable, it would be intriguing to explore whether declines are correlated with increased number of patients under a physician's care and/or the age distribution of their patients. A more detailed understanding of these contributing factors could help create strategies for optimizing care delivery in the future.

    Furthermore, I am curious about the historical context of comprehensiveness in family physician practice. Have previous studies compared eras such as the 1970s with the periods examined in this study (1999-2000 and 2017-2018)? Such a historical perspective could shed light on the trajectory of comprehensiveness in primary care over several decades and provide insights into whether decreases have been a continuous trend or marked by either short- or long-term variations.

    Exploration of potential temporal patterns is also an intriguing area for further investigation. Are there indications that the decrease in comprehensiveness has been accelerating in recent years, potentially indicating a worsening trend? Conversely, have there been periods of improvement or stability amidst the broader decline? Understanding these patterns could guide more targeted interventions and/or policy responses.

    In conclusion, the article by Lavergne and colleagues offers a valuable foundation for comprehending the dynamics of family physician practice comprehensiveness in Canada. The questions raised here highlight the potential for further research to provide a more nuanced and holistic view of this complex issue. I look forward to the prospect of additional studies that delve deeper into these questions, ultimately contributing to the enhancement of primary care practices.

    Show Less
    Competing Interests: None declared.
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The Annals of Family Medicine: 21 (2)
The Annals of Family Medicine: 21 (2)
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Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians
M. Ruth Lavergne, David Rudoler, Sandra Peterson, David Stock, Carole Taylor, Andrew S. Wilton, Sabrina T. Wong, Ian Scott, Kimberlyn M. McGrail, Rita McCracken, Emily G. Marshall, Adrian MacKenzie, Alan Katz, Margaret Jamieson, Lindsay Hedden, Agnes Grudniewicz, Laurie J. Goldsmith, Richard H. Glazier, Fred Burge, Doug Blackie
The Annals of Family Medicine Mar 2023, 21 (2) 151-156; DOI: 10.1370/afm.2945

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Declining Comprehensiveness of Services Delivered by Canadian Family Physicians Is Not Driven by Early-Career Physicians
M. Ruth Lavergne, David Rudoler, Sandra Peterson, David Stock, Carole Taylor, Andrew S. Wilton, Sabrina T. Wong, Ian Scott, Kimberlyn M. McGrail, Rita McCracken, Emily G. Marshall, Adrian MacKenzie, Alan Katz, Margaret Jamieson, Lindsay Hedden, Agnes Grudniewicz, Laurie J. Goldsmith, Richard H. Glazier, Fred Burge, Doug Blackie
The Annals of Family Medicine Mar 2023, 21 (2) 151-156; DOI: 10.1370/afm.2945
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