Beyond physician headcounts: a population-based analysis of regional physician practice patterns in northern Ontario,...

Northern Ontario faces persistent physician shortages, with recruitment and retention hindered by heavy workloads, professional isolation, and financial barriers. Reliance on physician headcounts alone does not capture the complexity of physician practice patterns and are inadequate for effective health human resource planning (HHRP).

To compare the demographic and practice characteristics of the physician workforce in four under-resourced specialties in Northern and Southern Ontario and assess the limitations of current approaches to HHRP.

Using the ICES Physician Database (IPDB) and Ontario Health Insurance Plan billing data for 2022, we characterized physicians in Northern and Southern Ontario according to demographics, headcounts, billing days, patient encounters, and clinical settings. Scott's Medical Database provided complementary headcount data. The analysis included physicians practicing family medicine, pediatrics, psychiatry, and obstetrics and gynecology. Categorical and continuous variables were summarized using proportions and means, respectively, and regional differences were assessed using standardized differences.

Physician demographics, practice comprehensiveness, and workload varied between Northern and Southern Ontario, reflecting differences in the delivery of care across geographic regions. Regional differences were observed in patient encounters, billing days, and the number of clinical settings in which physicians practiced. Physician headcounts also differed between Scott's Medical Database and the IPDB.

Physician practice patterns vary by population, geography, and health-system context. Workforce planning should account for regional variation in physician activity and scope of practice, use complementary data sources, and support locally tailored recruitment and retention strategies.