• Melad Marbeen, Thomas R Freeman, and Amanda L Terry.
• Adjunct Professor in the Department of Family Medicine at Western University in London, Ont. mmarbeen@uwo.ca.
• Can Fam Physician. 2022 Dec 1; 68 (12): 905914905-914.

ObjectiveTo determine factors associated with having a focused practice among a sample of family medicine graduates in Canada and to assess the characteristics of FPs with focused practices and the range of services provided by these FPs in relation to the full scope of office-based care.DesignSecondary analyses of cross-sectional data from the 2013-2014 Western Family Medicine Resident Follow-Up Survey.SettingWestern University in London, Ont.ParticipantsWestern University family medicine residency graduates who completed the program between 1985 and 2012.Main Outcome MeasuresPhysician and practice characteristics and the clinical services that survey participants provide.ResultsCompletion of postgraduate third-year (PGY3) training was associated with having a focused practice. Focused practice FPs were more likely to be remunerated by fee-for-service, alternative payment plans, or alternative funding plans compared with non-focused practice FPs, who were more likely to participate in group payment models. Focused practice FPs appeared to be a heterogeneous group who were distinguished by being either an office-based focused practice FP (OBFFP) or a non-office-based focused practice FP (NOBFFP). Office-based focused practice FPs were less likely than NOBFFPs to have completed PGY3 training and more likely to work under a fee-for-service or group payment model. Further, the OBFFP group offered a greater variety of primary care services than the NOBFFP group, but offered less variety than non-focused practice FPs.ConclusionCompletion of PGY3 training and payment through certain remuneration models were both associated with focused practice. Important differences exist between OBFFPs and NOBFFPs. The overall service provision of focused practice FPs was centred on specialized areas, especially among those practising in non-office-based settings. Novel findings from this study provide insights for family medicine education, work force planning, and policy making in the Canadian health system.Copyright © 2022 the College of Family Physicians of Canada.

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