なぜ総合診療科医は包括的ケアを離れるのか？オンタリオ州における定着に関する質的研究

A failure to retain family physicians already in practice is contributing to the current crisis for patients who are unable to access primary care. In this study we explored the reasons why Ontario family physicians left comprehensive care practice to identify what types of policies are critically needed for retention.

This qualitative study involved semistructured interviews, conducted in July-August 2024, with family physicians who left comprehensive care practice within the past 8 years. Virtual interviews were audio recorded, transcribed with double coding used for analysis and to identify categories from data. We sought participant validation of findings to enhance credibility and obtain feedback.

Twelve participants were included: 4 family physicians each in early, mid-, and late career stages. Policy areas viewed as critical for retaining family physicians include financial, systemic, administrative burden, and support for family medicine. Participants described their experiences and decisions to leave comprehensive practice with 113 specific priorities identified, which, if addressed, are seen to be able to limit attrition from family medicine.

Patients seeking access to primary care will continue to be thwarted because family physicians' careers are increasingly being shortened with early exits. Retention of practicing family physicians requires immediate attention from government, with the primary challenge related to financial stability of practices in Ontario. Although there are numerous system challenges in health care, addressing those that add burden to family physicians would lessen burnout and provide much needed supports to professionals who do not choose to leave careers lightly.