Promoting continuity of care: Enablers and barriers for new family physicians to work in regular family practice

Introduction: Continuity of care is the core of family practice and is a component of quality patient care. However, newly licensed family physicians in Quebec are less likely to work in a regular family practice (providing long-term follow-up to a defined panel of patients) than their more experienced counterparts. This contributes to a relative shortage of medical staff in primary care in Quebec. This study aimed to analyze the factors that influence whether newly licensed family physicians work in regular family practice.   

Methods: A mixed-methods study was conducted, consisting of a self-administered questionnaire followed by in-depth interviews.  A web-based survey was sent to all family physicians working in the Monteregie region of Quebec that had 10 or fewer years of working experience (n=370). In-depth follow-up interviews were then conducted with 10 respondents working in diverse family practice settings.

Results: The response rate was 32.2% (118/370). Enablers included the doctor-patient relationship, interest in clinical activities in family practice, positive role models, collaboration with a nurse, and access to technical and human resources. Barriers included administrative workloads, interest in hospital work, negative training experiences in regular family practice, and lack of support in the first years of practice.

Conclusion: The following strategies may attract newly licensed family physicians to regular family practice: 1) Improving training experiences in regular family practice, 2) reduce administrative workloads, 3) improve access to diagnostic and specialized resources, 4) support interprofessional collaboration in primary care, and 5) support mentorship in the first years of practice.