Don’t blame the young ones: Study finds reductions in service offerings are similar among early-career and experienced family doctors

Do new family doctors tend to offer fewer services than their more established peers? Several studies have suggested that this is indeed the case, and that the narrower range of services among early-career family physicians is driven largely by inadequate training or just plain lack of interest. But a recent review of administrative billing and shadow-billing by family physicians in British Columbia, Manitoba, Ontario and Nova Scotia refutes this conclusion. The study, which looked at billing data submitted from 1999 to 2000 and 2017 to 2018, found that while comprehensiveness of service offerings declined during these periods in all provinces, the decreases were not greater among new-to-practice physicians compared to those with more years of experience. The findings from the study, which were published in March 2023 in the Annals of Family Medicine, could have implications for health system policies. Had researchers come to a different conclusion, for example, a policy response might suggest targeted interventions during formative stages of training and in early career stages. Read: Report calls for restricting marketing to kids in grocery stores, restaurants The research team—which included physicians and researchers from each of the provinces analyzed—looked at billing data across seven healthcare settings (home, long-term care, emergency department, hospital, obstetrics, surgical assistance and anesthesiology) and seven service areas (pre- and post-natal care, Pap testing, mental health, substance use, cancer care, minor surgery and palliative home visits). The goal of the review was to test the hypothesis that declines in comprehensiveness over time is greater among doctors within their first 10 years of practice than among physicians in practice for 10 or more years. Their findings? The numbers revealed that the mean number of service settings in which physicians had contacts decreased in all provinces by 1 to 1.7 settings, while the number of service areas decreased by 0.3 to 0.5 areas. In the earlier period analyzed—between 1999 to 2000—physicians in their first 10 years did practise in fewer service settings on average than more experienced doctors. However the data from 2017 to 2018 showed a shift in patterns: during this period, physicians in their first 10 years had similar or more mean service settings than physicians in practice for 10 or more years. When it came to service areas during both periods, physicians in their first 10 years had similar mean service areas to those in practice longer. Read: Understanding the communication needs of deaf patients

Don’t blame the young ones: Study finds reductions in service offerings are similar among early-career and experienced family doctors

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