Family physicians’ perspectives on collaboration challenges between primary care and specialist care during the COVID-19 pandemic in Canada: A qualitative study

• Published in: SSM - Qualitative Research in Health
• Main Authors: Lauren R. Moritz, Richard Buote, Madeleine McKay, Leslie Meredith, Dana Ryan, Sarah Spencer, Crystal Vaughan, Lindsay Hedden, Julia Lukewich, Maria Mathews, Shabnam Asghari, Judith Belle Brown, Paul S. Gill, Eric Wong, Emily Gard Marshall
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier 2023
• Subjects: Physicians; Primary care; COVID-19; Referral; Consultation; Collaboration; Public aspects of medicine; RA1-1270; British Columbia; Canada; Newfoundland
• Online Access: https://doi.org/10.1016/j.ssmqr.2023.100338; https://doaj.org/article/0776556203f54fcf8374ad2c3b8f3a39

Background: Prior to the COVID-19 pandemic, Canada had longer wait-times for specialist appointments compared to other Commonwealth countries. During the pandemic, many specialist services were postponed or suspended, impacting access. The purpose of this study was to explore family physicians’ perspectives on specialist care availability during the pandemic and implications for family physician workload and patient management. These experiences can inform future pandemic plans. Methods: Using semi-structured interviews, we explored family physicians’ experiences during COVID-19 across regions within four Canadian provinces (British Columbia, Ontario, Nova Scotia, Newfoundland and Labrador). Thematic and framework analyses were used to identify themes from the interviews. Results: We interviewed 68 family physicians between October 2020 and June 2021. Of these 68 participants, 27 discussed their interactions with specialists during the pandemic. We identified themes around access to, and collaboration with, specialists. At times, specialists were less available for patient care and family physician consultations, and communications were uncoordinated across the system. Family physicians took on additional work to address the lack of access and identified pandemic planning challenges. Participants offered recommendations for improving collaboration and access post-pandemic. Interpretation: The COVID-19 pandemic exacerbated existing challenges in the Canadian healthcare system pertaining to specialist access. Pandemic plans should reflect the importance of specialist consultations. Decision-makers should consider innovations to facilitate collaboration between family physicians and specialists.