RT Journal Article
SR Electronic
T1 Family Physicians in Focused Practice in Ontario, Canada: A Population-Level Study of Trends From 1993/1994 Through 2021/2022
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 181
OP 190
DO 10.1370/afm.240377
VO 23
IS 3
A1 Ansari, Hina
A1 Glazier, Richard H.
A1 Schultz, Susan E.
A1 Green, Michael E.
A1 Premji, Kamila
A1 Frymire, Eliot
A1 Daneshvarfard, Maryam
A1 Jaakkimainen, Liisa
A1 Kiran, Tara
YR 2025
UL http://www.annfammed.org/content/23/3/181.abstract
AB PURPOSE An adequate supply of family physicians who deliver comprehensive care is critical for addressing evolving population health needs, fostering health equity, and ensuring a cost-effective health system. Little is known about current trends of family physicians choosing focused practice and concurrent changes in comprehensive family physician numbers relative to population growth.METHODS We conducted a repeated cross-sectional population-based study using administrative data to understand sex-stratified trends in focused practice from 1993/1994 through 2021/2022 in Ontario, Canada, accounting for population growth. For each fiscal year, we identified all active family physicians and classified them by practice type, leveraging a previously published algorithm on comprehensiveness.RESULTS The proportion of family physicians in focused practice increased from 7.7% (856/11,103) in 1993/1994 to 19.2% (3,351/17,413) in 2021/2022. The 3 most prevalent focused practice types at the end of the study period were emergency (37.0%), hospitalist (26.5%), and addiction (8.3%) medicine. A greater proportion of focused practice physicians were male (60.1%) vs female (39.9%) in 2021/2022. Over the study period, the number of family physicians increased from 104 to 118 per 100,000; however, the number of comprehensive family physicians decreased from 71 to 64 per 100,000. Of the additional 6,310 family physicians who entered the workforce, 39.5% (2,495/6,310) were in focused practice.CONCLUSIONS Over the study period, there was a decrease in the percentage of comprehensive family physicians and a substantial increase in family physicians pursuing focused practice, particularly in emergency and hospitalist medicine. Research and policy work is needed to understand and address the complex factors driving these trends.