The roles of family physicians during a pandemic

Abstract

Family physicians play important roles throughout all stages of a pandemic response; however, actionable descriptions outlining these roles are absent from current pandemic plans. Using a multiple case study design, we conducted a document analysis and interviewed 68 family physicians in four Canadian regions. We identified roles performed by family physicians in five distinct stages of pandemic response: pre-pandemic, phased closure and re-opening, acute care crisis, vaccination, and pandemic recovery. In addition to adopting public health guidance to ensure continued access to primary care services, family physicians were often expected to operationalize public health roles (eg, staffing assessment centres), modulate access to secondary/tertiary services, help provide surge capacity in acute care facilities, and enhance supports and outreach to vulnerable populations. Future pandemic plans should include family physicians in planning, explicitly incorporate family physician roles, and ensure needed resources are available to allow for an effective primary care response.

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

“…In each interview, we asked FPs to describe the various pandemic-related roles they performed over different stages of the pandemic and the facilitators and barriers they experienced in performing these roles, as well as other potential roles that FPs could have filled (Appendix A) [26]. We also gathered information about their background and practice characteristics.…”

Brief on Primary Care Part 1: The Roles of Primary Care Clinicians and Practices in the First Two Years of the COVID-19 Pandemic in Ontario

“…In Canada 9 and internationally, [10][11][12][13][14][15] in many regions, the pandemic sparked or accelerated collaboration and information sharing between primary care clinicians. These informal networks could collectively respond to new pandemic demands in collaboration with hospitals, long-term care, public health, paramedic services, and social care.…”

“…4 The international community has therefore repeatedly called for a focus on strengthening primary health care both in general, and in particular to support COVID-19 pandemic response and recovery. [5][6][7][8] In Canada 9 and internationally, [10][11][12][13][14][15] PCCs often support upstream efforts to address health disparities with an equity-lens that considers the social determinants of health. 16 Ontario, with its population of over 14.8 million people and projected growth of 5.6 million people over the next 25 years, 17 has a large and growing demand for primary care.…”

Brief on Primary Care Part 2: Factors Affecting Primary Care Capacity in Ontario for Pandemic Response and Recovery

“…During that time, beyond ongoing primary care services for their patients, family physicians have taken on multiple roles, including managing infections in the office and through remote care; supporting public health (e.g., by staffing assessment and vaccination centres); providing surge capacity in acute care settings; and supporting outreach to equity-deserving populations. 30 In the later and ongoing stages of the pandemic, there has been extraordinary pressure to keep emergency departments (EDs) open. To this end, in many rural communities, family physicians practicing in the local primary care practice also provide ED services.…”