• David Rudoler, Sandra Peterson, David Stock, Carole Taylor, Drew Wilton, Doug Blackie, Fred Burge, Richard H Glazier, Laurie Goldsmith, Agnes Grudniewicz, Lindsay Hedden, Margaret Jamieson, Alan Katz, Adrian MacKenzie, Emily Marshall, Rita McCracken, Kim McGrail, Ian Scott, Sabrina T Wong, and M Ruth Lavergne.
• Faculty 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.
• CMAJ. 2022 Dec 12; 194 (48): E1639E1646E1639-E1646.

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.© 2022 CMA Impact Inc. or its licensors.

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