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

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.