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Research ArticleResearch

Predicting the scope of practice of family physicians

Eric Wong and Moira Stewart
Canadian Family Physician June 2010; 56 (6) e219-e225;
Eric Wong
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  • For correspondence: mdericwong@gmail.com
Moira Stewart
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    Table 1.

    Characteristics of sample of FPs and GPs: Analytic weighting was used; N = 6789.

    INDEPENDENT VARIABLEN (%)MEAN SCOPE OF PRACTICE SCORE (SD)
    Physician-related variables
    Physician age,* y
      • < 35745 (11.0)8.8 (1.9)
      • 35 to 442308 (34.0)8.7 (2.0)
      • 45 to 542502 (36.9)8.7 (2.1)
      • 55 to 64965 (14.2)8.6 (2.2)
      • ≥ 65269 (4.0)7.6 (2.5)
    Years in medical practice†
      • 0 to 101679 (24.7)8.9 (1.9)
      • 11 to 202452 (36.1)8.7 (2.1)
      • 21 to 301986 (29.2)8.6 (2.2)
      • 31 to 40540 (8.0)8.3 (2.3)
      • > 40132 (1.9)7.6 (2.4)
    Physician sex
      • Male4472 (65.9)8.8 (2.1)
      • Female2317 (34.1)8.3 (2.0)
    Additional postgraduate training after family medicine residency
      • Yes2391 (35.2)8.9 (2.1)
      • No4398 (64.8)8.5 (2.1)
    Physician payment type
      • Fee-for-service only3051 (44.9)8.3 (2.2)
      • Other3738 (55.1)8.9 (1.9)
    Availability of health care resources to main practice setting
    Referral to specialists‡
      • 1 (poor)503 (7.4)8.7 (2.1)
      • 22051 (30.2)8.8 (2.0)
      • 32607 (38.4)8.7 (2.0)
      • 41252 (18.4)8.4 (2.2)
      • 5 (excellent)375 (5.5)8.2 (2.4)
    Hospital beds§
      • 1 (poor)1720 (25.3)8.7 (2.0)
      • 22421 (35.7)8.6 (2.1)
      • 31738 (25.6)8.5 (2.1)
      • 4695 (10.2)8.9 (2.1)
      • 5 (excellent)215 (3.2)9.3 (2.1)
    Practice organization
    No. of different types of allied health professionals in main practice setting||
      • 0 to 25936 (87.4)8.8 (2.1)
      • 3 to 5791 (11.7)8.0 (2.0)
      • ≥ 662 (0.9)7.4 (2.1)
    Main practice setting
      • Private office or clinic6101 (89.9)8.7 (2.1)
      • Community clinic, CHC, CLSC468 (6.9)7.9 (2.2)
      • Academic family medicine teaching unit220 (3.2)8.9 (1.7)
    Practice type
      • Solo practice1619 (23.9)8.4 (2.2)
      • Family physician group practice4512 (66.5)8.8 (2.0)
      • Family physician–specialist group practice658 (9.7)7.9 (2.3)
    Geographic variables
    Population served¶
      • Urban4291 (63.2)8.2 (2.1)
      • Semiurban1363 (20.1)9.2 (2.0)
      • Rural1135 (16.7)9.7 (1.6)
    Provinces#
      • Newfoundland and Labrador114 (1.7)9.0 (1.8)
      • Prince Edward Island68 (1.0)9.4 (1.6)
      • New Brunswick135 (2.0)9.7 (1.5)
      • Nova Scotia248 (3.6)9.4 (1.6)
      • Quebec1450 (21.4)7.2 (2.0)
      • Ontario2550 (37.6)8.6 (2.0)
      • Manitoba209 (3.1)8.8 (2.0)
      • Saskatchewan209 (3.1)10.1 (1.3)
      • Alberta628 (9.3)9.3 (1.9)
      • British Columbia1178 (17.4)9.7 (1.5)
    • CHC—community health centre, CLSC—centre local de services communautaires.

    • ↵* Mean (SD) physician age was 46.2 (9.5) years.

    • ↵† Mean (SD) number of years in practice was 18.0 (9.6) years.

    • ↵‡ Availability of specialists for referral was scored on a 5-point Likert scale (with 1 being poor and 5 being excellent). Mean (SD) Likert score for availability of specialists was 2.9 (1.0).

    • ↵§ Access to hospital beds was scored on a 5-point Likert scale (with 1 being poor and 5 being excellent). Mean (SD) Likert score for access to hospital beds was 2.3 (1.1).

    • ↵|| The mean (SD) number of allied health professionals in the main practices settings was 1.1 (1.3).

    • ↵¶ This referred to the population primarily served by the respondent’s practice, as selected by the respondent. The original categories of inner city and urban-suburban were collapsed into urban; small town was collapsed into semiurban; and rural, geographically isolated, and remote were collapsed into rural.

    • ↵# Complete-case analysis excluded all respondents from the territories.

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    Table 2.

    Results of univariable and multivariable analyses with complete case analysis: N = 6789.

    INDEPENDENT VARIABLES (REFERENCE CATEGORY)UNADJUSTED β (UNSTANDARDIZED REGRESSION COEFFICIENT)STANDARD ERROR OF UNADJUSTED βUNADJUSTED R2ADJUSTED β (UNSTANDARDIZED REGRESSION COEFFICIENT)STANDARD ERROR OF ADJUSTED βADJUSTED R2(% OF TOTALR2EXPLAINED)
    Physician-related variables
    Physician age−0.24*0.040.005*−0.16*0.040.002 (0.6)*
    Years in medical practice†−0.25*0.040.006*
    Male physician sex8.55*0.820.016*6.20*0.720.006 (1.7)*
    Additional postgraduate training after family medicine residency6.97*0.820.011*3.22*0.680.002 (0.6)*
    Payment via fee-for-service only−10.12*0.780.024*−7.88*0.680.016 (4.6)*
    Availability of health care resources to main practice setting
    Specialists−2.08*0.400.004*−1.13*0.350.001 (0.3)‡
    Hospital beds1.09*0.370.001‡0.97‡0.360.001 (0.3)‡
    Practice organization
    No. of different types of allied health professionals in main practice setting−2.84*0.300.013*1.33*0.310.002 (0.6)*
    Main practice setting (private office)0.010*0.009 (2.6)*
      • Community clinic, CHC, CLSC−12.32*1.55−11.87*1.50
      • Academic family medicine teaching unit2.24§2.228.97*1.90
    Practice type (solo practice)0.019*0.007 (2.0)*
      • Family physician group practice6.58*0.935.35*0.81
      • Family physician–specialist group practice−7.30*1.491.95§1.32
    Geographic variables0.095*0.110 (31.3)*
    Population served (urban)
      • Semiurban16.43*0.9617.20*0.86
      • Rural24.57*1.0323.96*0.97
    Provinces (Quebec)0.195*0.195 (55.6)*
      • Newfoundland and Labrador28.75*2.8326.89*2.59
      • Prince Edward Island35.07*3.6229.91*3.28
      • New Brunswick39.73*2.6337.65*2.40
      • Nova Scotia34.64*2.0034.54*1.85
      • Ontario21.87*0.9627.31*0.94
      • Manitoba26.33*2.1626.07*1.97
      • Saskatchewan47.54*2.1648.29*1.99
      • Alberta33.54*1.3935.52*1.31
      • British Columbia40.00*1.1443.68*1.14
    • CHC—community health centre, CLSC—centre local de services communautaires.

    • ↵* P < .001.

    • ↵† Excluded or not significant in multivariable model.

    • ↵‡ P < .01.

    • ↵§ P > .05 (not significant).

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Canadian Family Physician: 56 (6)
Canadian Family Physician
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1 Jun 2010
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Predicting the scope of practice of family physicians
Eric Wong, Moira Stewart
Canadian Family Physician Jun 2010, 56 (6) e219-e225;

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