PT  - JOURNAL ARTICLE
AU  - Rudoler, David
AU  - Peterson, Sandra
AU  - Stock, David
AU  - Taylor, Carole
AU  - Wilton, Drew
AU  - Blackie, Doug
AU  - Burge, Fred
AU  - Glazier, Richard H.
AU  - Goldsmith, Laurie
AU  - Grudniewicz, Agnes
AU  - Hedden, Lindsay
AU  - Jamieson, Margaret
AU  - Katz, Alan
AU  - MacKenzie, Adrian
AU  - Marshall, Emily
AU  - McCracken, Rita
AU  - McGrail, Kim
AU  - Scott, Ian
AU  - Wong, Sabrina T.
AU  - Lavergne, M. Ruth
TI  - Changes over time in patient visits and continuity of care among graduating cohorts of family physicians in 4 Canadian provinces
AID  - 10.1503/cmaj.220439
DP  - 2022 Dec 12
TA  - Canadian Medical Association Journal
PG  - E1639--E1646
VI  - 194
IP  - 48
4099  - http://www.cmaj.ca/content/194/48/E1639.short
4100  - http://www.cmaj.ca/content/194/48/E1639.full
SO  - CMAJ2022 Dec 12; 194
AB  - Background: Lack 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.Methods: We 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.Results: Between 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.Interpretation: Recent 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.See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.221563