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Understanding issues in primary care: perspectives of primary care physicians

Nelly D Oelke , Wilfreda E Thurston , Remo Dipalma , Wendy Tink , Josephine N Mazonde , Allan Mak BA , Gail D Armitage MA

Objective To explore and describe the perceptions of family physicians in a large urban centre regarding issues in primary care and to identify those issues that would impact provision of care in a primary care setting.Design Cross-sectional survey using interviews.Setting Urban centre in western Canada.Participants Eighty-two family physicians located in the central core of a large urban centre.Method Semi-structured interviews and thematic analysis were used to collect and analyse the data. Main findings Physicians identified a number of interrelated issues in community family practice including high overheads,time,lifestyle and family commitments,staffin g issues,lack of communication among providers and between providers and the health region,and technology. These issues impacted their quality of work life,caus ing a sense of being overwhelmed,frust rated,isolated,pow erless anddisillusioned. The participants recommended changes that would benefit their practices,family medicine, and primary care reform.Conclusion Family practice is at a crossroads and new models of team-based care and alternative funding strategies are the preferred methods of implementing primary care reform.