Future role of the personal physician in Canada

Subthemes of the yes theme

Patients want it: This subtheme describes patients’ desire for a personal physician. One respondent wrote, “People know what they want if they have had a personal physician. They need to organize and demand this type of care” (age 69).

Personal relationships: This subtheme presents the importance of the relationship between doctor and patient. As one respondent explained, “Patients and society expect and need a personal physician to care for them in a way that no specialist can, someone who knows them, not just their disease” (age 26).

Coordinators of care: This subtheme explains that the personal physician is necessary in order to manage and oversee each patient’s care. One respondent wrote, “In my 32 years of practice, I have seen my role and the role of my colleagues become more important, not less, as people find their health care more difficult to negotiate” (age 56). Additionally, many participants described personal physicians as “the gatekeepers of medicine.”

Care over the life course: One respondent described this subtheme as follows: “Health runs over the life course and continuity of care provides an understanding of the patient over time” (age 38).

Subthemes of the maybe theme

System pressures: This subtheme explains how decreased resources and pressure from the government might affect the future of the personal physician. “With increased constraints and decreased resources in our health care system, we don’t have the infrastructure [or] supports to be the kind of family physician we want to be” (age 27).

Another respondent described the issue as a battle between family physicians and funders, explaining that they are “uncertain as of yet which ‘side’ is going to ‘win’” (age 39).

Loss of the philosophy: This subtheme explains that many current family medicine practitioners no longer identify with the original humanistic aspect of the field. One respondent wrote, “Physicians are not doing medicine as a calling anymore. Eight-minute visits; ‘I don’t do housecalls’; ‘I don’t have time or interest’” (age 67).

Another respondent wrote, “Not all family physicians view their practice as an opportunity to improve the overall health of their patients, but rather as a set volume [or] number of people to see within a given day” (age 26).

Evolution of medicine: This subtheme explains how the field of medicine has always evolved and will continue to do so. One participant wrote that “historically, populations may [or] may not have had a ‘personal physician’ (because of various factors) so, same applies in future” (age 46).

Another respondent feared that “technology may take over” (age 50).

Subthemes of the no theme

Replacement of the personal physician: This subtheme describes mechanisms already in place that have begun to replace the personal physician’s role. One respondent wrote, “No, sadly, with the growing shortage of primary care physicians and increasing use of Dr Google, the idea of the personal physician is dying” (age 31).

Multiple respondents also highlighted that the move toward team-based care has replaced the personal physician as patients are usually seen by a different physician each time they visit the clinic.

Putting the system before the person: This subtheme explains how the health care system is monetizing patient care. For example, one respondent wrote the following: “Personal experience with the current system and costs. The government is prepared to control it” (age 74).

Another respondent explained, “We are putting the system first” (age 47).