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Health Aff (Millwood). 2017 Nov;36(11):1904-1911. doi: 10.1377/hlthaff.2017.0014.

In British Columbia, The Supply Of Primary Care Physicians Grew, But Their Rate Of Clinical Activity Declined.

Author information

1
Lindsay Hedden ( lindsay.hedden@ubc.ca ) is a postdoctoral fellow in the Centre for Clinical Epidemiology and Evaluation, School of Population and Public Health, University of British Columbia, in Vancouver.
2
Morris L. Barer is a professor in the Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia.
3
Kimberlyn McGrail is an associate professor in the Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia.
4
Michael Law is an associate professor in the Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia.
5
Ivy L. Bourgeault is a professor in the Telfer School of Management, University of Ottawa, in Ontario.

Abstract

Reports of a primary care shortage are ubiquitous in Canada and the United States. We used a population-based, retrospective cohort study to examine the extent to which the feminization and aging of the primary care physician workforce and secular trends may contribute to changes in the availability of primary care services. We used billing data for all primary care physicians in British Columbia for the period 2005-12. We used multivariate linear mixed-effects models to study physician remuneration and activity levels. We found limited change in per physician remuneration over the study period. However, numbers of patient contacts and practice sizes (numbers of unique patients) declined by 14 percent and 10 percent, respectively. Although the feminization of the workforce-and, to a lesser extent, its aging-contributed to this decline, the primary driver appears to be a broad trend toward reduced clinical activity over time. To the extent that similar trends are occurring in the United States, the implications of our study for the availability of primary care services beyond Canada are potentially significant.

KEYWORDS:

Physicians; Primary health care; health human resources; workforce planning

PMID:
29137511
DOI:
10.1377/hlthaff.2017.0014
[Indexed for MEDLINE]

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