• Tara Kiran, Maryam Daneshvarfard, Ri Wang, Alexander Beyer, Jasmin Kay, Mylaine Breton, Danielle Brown-Shreves, Amanda Condon, Michael E Green, Lindsay Hedden, Alan Katz, Maggie Keresteci, Neb Kovacina, M Ruth Lavergne, Aisha Lofters, Danielle Martin, Goldis Mitra, Sarah Newbery, Katherine Stringer, Peter MacLeod, and Clifton van der Linden.
• Department of Family and Community Medicine (Kiran, Lofters, Martin), Temerty Faculty of Medicine, University of Toronto; Department of Family and Community Medicine (Kiran), and MAP Centre for Urban Health Solutions (Kiran, Daneshvarfard, Wang), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Kiran, Martin), University of Toronto, Toronto, Ont.; Department of Political Science (Beyer, van der Linden), McMaster University, Hamilton, Ont.; Vox Pop Labs (Beyer, van der Linden); MASS LBP (Kay, MacLeod), Toronto, Ont.; Department of Community Health (Breton), Université de Sherbrooke, Longueuil, Que.; Department of Family Medicine (Brown-Shreves), University of Ottawa; Restore Medical Clinics (Brown-Shreves), Ottawa, Ont.; Department of Family and Community Medicine (Brown-Shreves), Queen's University, Kingston, Ont.; Department of Family Medicine (Condon), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Green), and Health Services and Policy Research Institute (Green), Queens University; ICES Queen's (Green), Kingston, Ont.; Faculty of Health Sciences (Hedden), Simon Fraser University, Burnaby, BC; Departments of Community Health Sciences and Family Medicine (Katz), University of Manitoba, Winnipeg, Man.; Canadian Association for Health Services and Policy Research (Keresteci), Ottawa, Ont.; Department of Family Medicine (Kovacina), McGill University, Montréal, Que.; Department of Family Medicine (Lavergne, Stringer), Dalhousie University, Halifax, NS; Peter Gilgan Centre for Women's Cancers (Lofters), and Department of Family and Community Medicine (Martin), Women's College Hospital, Toronto, Ont.; Department of Family Practice (Mitra), University of British Columbia, Vancouver, BC; Clinical Faculty (Newbery), Section of Family Medicine, NOSM University, Thunder Bay, Ont. tara.kiran@utoronto.ca.
• CMAJ. 2024 May 20; 196 (19): E646E656E646-E656.

BackgroundThrough medicare, residents in Canada are entitled to medically necessary physician services without paying out of pocket, but still many people struggle to access primary care. We conducted a survey to explore people's experience with and priorities for primary care.MethodsWe conducted an online, bilingual survey of adults in Canada in fall 2022. We distributed an anonymous link through diverse channels and a closed link to 122 053 people via a national public opinion firm. We weighted completed responses to mirror Canada's population and adjusted for sociodemographic characteristics using regression models.ResultsWe analyzed 9279 completed surveys (5.9% response rate via closed link). More than one-fifth of respondents (21.8%) reported having no primary care clinician, and among those who did, 34.5% reported getting a same or next-day appointment for urgent issues. Of respondents, 89.4% expressed comfort seeing another team member if their doctor recommended it, but only 35.9%, 9.5%, and 12.4% reported that their practice had a nurse, social worker, or pharmacist, respectively. The primary care attribute that mattered most was having a clinician who "knows me as a person and considers all the factors that affect my health." After we adjusted for respondent characteristics, people in Quebec, the Atlantic region, and British Columbia had lower odds of reporting a primary care clinician than people in Ontario (adjusted odds ratio 0.30, 0.33, and 0.39, respectively; p < 0.001). We also observed large provincial variations in timely access, interprofessional care, and walk-in clinic use.InterpretationMore than 1 in 5 respondents did not have access to primary care, with large variation by province. Reforms should strive to expand access to relationship-based, longitudinal care in a team setting.© 2024 CMA Impact Inc. or its licensors.

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