Family Physician Practice Patterns During COVID-19 and Future Intentions: Cross-sectional Survey in Ontario, Canada

Objective: To determine the extent to which family physicians closed their doors altogether or for in-person visits during the pandemic, their future practice intentions, and related factors.

Design: Cross-sectional survey.

Setting: Six geographic areas in Toronto, Ont, aligned with Ontario Health Team regions.

Participants: Family doctors practising office-based, comprehensive family medicine.

Main Outcome Measures: Practice operations in January 2021, use of virtual care, and future plans.

Results: Of the 1016 (85.7%) individuals who responded to the survey, 99.7% (1001 of 1004) indicated their practices were open in January 2021, with 94.8% (928 of 979) seeing patients in person and 30.8% (264 of 856) providing in-person care to patients reporting COVID-19 symptoms. Respondents estimated spending 58.2% of clinical care time on telephone visits, 5.8% on video appointments, and 7.5% on e-mail or secure messaging. Among respondents, 17.5% (77 of 439) were planning to close their existing practices in the next 5 years. There were higher proportions of physicians who worked alone in clinics among those who did not see patients in person (27.6% no vs 12.4% yes, <.05), among those who did not see symptomatic patients (15.6% no vs 6.5% yes, <.001), and among those who planned to close their practices in the next 5 years (28.9% yes vs 13.9% no, <.01).

Conclusion: Most family physicians in Toronto were open to in-person care in January 2021, but almost one-fifth were considering closing their practices in the next 5 years. Policy makers need to prepare for a growing family physician shortage and better understand factors that support recruitment and retention.