Family Medicine Profile Updated December 2019 1 Table of Contents General Information Total number & number/100,000 population by province, 2019 Number/100,000 population, 1995-2019 Number by gender & year, 1995-2019 Percentage by gender & age, 2019 Number by gender & age, 2019 Percentage by main work setting, 2019 Percentage by practice organization, 2017 Hours worked per week (excluding on-call), 2019 On-call duty hours per month, 2019 Percentage by remuneration method Professional & work-life balance satisfaction, 2019 Number of retirees during the three year period of 2016-2018 Employment situation, 2017 Links to additional resources Slide 3-6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 General information Family medicine is the main primary care medical specialty in Canada. It focuses care on the individual within the context of the family and the community. Family physicians (refers to both family physicians and general practitioners) deliver services across the entire spectrum of care, regardless of patient age, sex or condition. Public polls repeatedly confirm how highly the people of Canada value family doctors for their roles in caring for them. While family medicine may seem the most “general” of the specialties, it is in fact, a precise discipline, integrating a unique blend of biomedical, behavioural and social sciences, while employing a diverse range of cognitive and procedural skills. Source: Pathway evaluation program 3 General information The family physician is often called upon to deal with undifferentiated clinical problems presenting at an early stage. In addition to acute disorders, which are sometimes life-threatening, there is a high frequency of chronic diseases, emotional problems and transient illnesses. Family physicians deliver care across a wide spectrum of settings, including their offices, hospital, longterm and other health care facilities and the patient’s home. The close, long-term physician-patient relationship that is established, the diversity in the work and the variety of practice opportunities offered by family medicine are some of the main factors that attract physicians to this specialty. Family physicians also play an important role in health promotion and illness prevention, coordinating care with other specialties and health professionals, and advocating on behalf of their patients with respect to the care and services they need in all parts of the health care system. Source: Pathway evaluation program 4 General information Upon completion of medical school, to become certified in family medicine with the College of Family Physicians of Canada (CFPC) requires an additional 2 years of postgraduate training. This includes experiences in family practice settings; general surgery; internal medicine; pediatrics; obstetrics/gynaecology; psychiatry and emergency medicine; as well as opportunities for electives in areas selected by each resident. The training environment includes hospitals but is also very focused on experiences in community-based practices, including opportunities in small town and rural settings. While most residents are well prepared to enter practice after 2 years of postgraduate training, some with specific needs or interests might benefit from additional or enhanced skills training and apply to a number of positions available for an optional third year. Examples of such third year programs include emergency medicine, palliative care, maternity care and care of elderly. Source: Pathway evaluation program 5 General information The main objective of additional training is to prepare graduates to be able to offer added services to patients as part of their broad-based or comprehensive continuing care family practices. Following the completion of residency, there is a certification examination to evaluate competence in the specialty of family medicine. If successful, the resident will be awarded Certification in The College of Family Physicians of Canada (CCFP) that is then maintained throughout their career through participation in the College’s life-long learning (continuing professional development) program. For further details on training requirements please go to: College of Family Physicians of Canada Source: Pathway evaluation program 6 Total number & number/100,000 population by province, 2019 Province/Territory Physicians Phys/100k pop'n Newfoundland/Labrador 927 177 Prince Edward Island 174 112 Nova Scotia 1292 134 New Brunswick 1153 149 Quebec 10909 129 Ontario 14962 104 Manitoba 1519 112 Saskatchewan 1395 119 Alberta 5758 133 British Columbia 6366 127 Territories 129 104 CANADA 44584 119 Source: 2019 CMA Masterfile 7 Number/100,000 population, 1995 to 2019 120 115 110 105 100 95 90 1995 1997 1999 Source: 1995-2019 CMA Masterfiles 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019 8 Number by gender & year, 1995 to 2019 50000 45000 40000 35000 30000 25000 20000 15000 10000 5000 0 1995 1997 1999 2001 2003 Total Source: 1995-2019 CMA Masterfiles 2005 2007 Males 2009 2011 2013 2015 2017 2019 Females 9 Percentage by gender & age, 2019 Gender Age Group 8% 17% 24% 47% 53% 30% 26% Male Female 65+ 55 - 64 45 - 54 35 - 44 < 35 Excludes those where gender or age is unknown. Source: 2019 CMA Masterfile 10 Number by gender & age, 2019 65+ 1806 55-64 4586 45-54 6359 5050 35-44 <35 5299 5419 5768 2790 4211 1566 Female Includes General Practitioners and non-certified specialists Excludes those where gender or age is unknown. Source: 2019 CMA Masterfile Male 11 Percentage by main work setting, 2019 Private Office/Clinic 58% Community Clinic/Health-centre 10% Emergency Dept 7% Community Hospital 7% Other 5% Academic Health Sciences Centre 4% Free-standing Walk-in Clinic 3% * Includes General Practitioners Source: 2019 CMA Physician Workforce Survey. Canadian Medical Association 12 Percentage by practice organization, 2017* 1% 19% 15% Solo Practice Group Practice Interprofessional Practice Hospital-based Practice 25% 39% * Most recent available data for this specialty * Includes General Practitioners and non-certified specialists Source: 2017 CMA Workforce Survey. Canadian Medical Association NR 13 Hours worked per week (excluding on-call), 2019 Activity Hours worked per week Direct patient care without teaching component 27.6 Direct patient care with teaching component 4.0 Teaching without patient care 0.9 Indirect patient care 8.2 Health facility committees 0.6 Administration 2.0 Research 0.4 Managing practice 1.4 Continued professional development 2.4 Other 0.4 TOTAL HOURS PER WEEK 47.9 * Includes General Practitioners Source: 2019 CMA Physician Workforce Survey. Canadian Medical Association 14 On-call duty hours per month, 2019 63% provide on-call services On-call hours = 111 hours/month On-call hours spent in direct patient care = 30 hours/month * Includes General Practitioners Source: 2019 CMA Workforce Survey. Canadian Medical Association 15 Percentage by remuneration method Primary payment method1 in 2017 1% 39% Average gross payment per physician for Family Medicine in 2017/18 (those earning at least $60,000) = $308,3172 44% Average percent overhead reported in 2017 = 27%3 11% 5% 90% + fee-for-service 90% + other* NR 90% + salary Blended *Other includes capitation, sessional, contract and other methods 2017 CMA Workforce Survey. Canadian Medical Association National Physician Database, 2017/18, CIHI 3 2017 CMA Workforce Survey. Canadian Medical Association 1 2 16 Professional & work-life balance satisfaction, 2019 Balance of personal & professional commitments Current professional life NR 30% 13% 22% 48% 16% Dissatisfied or very dissatisfied 71% Neutral Satisfied or very satisfied * Includes General Practitioners Source: 2019 CMA Physician Workforce Survey. Canadian Medical Association 17 Number of retirees during the three year period of 2016-2018 Male Female 1118 938 512 276 152 172 1 13 34 and Under 6 25 35-44 16 23 45-54 5 55-64 65 and over 3 Unknown Total Age Group Source: CMA Masterfile – year over year comparisons Note: “Retired” is based on giving up licence and therefore excludes those who have retired from clinical practice but are still licensed; those younger than 45 may include physicians who have temporarily given up their licence but return to practice at a later date. 18 Employment situation, 2017 3% 1% 1% 34% Overworked in my discipline Employed in my discipline to my satisfaction Underemployed in my discipline Not employed in my discipline No response 61% Source: 2017 CMA Workforce Survey. Canadian Medical Association 19 Links to additional resources Association of Faculties of Medicine of Canada Canadian Institute for Health Information Canadian Medical Association’s Physician Data Centre Canadian Post-MD Education Registry (CAPER) College of Family Physicians of Canada National Physician Survey (2004-2014) Royal College of Physicians and Surgeons of Canada 20