To stay or leave: an integrative review of factors, personas, and recommendations for retaining family physicians in Canada
Notice bibliographique
Résumé
INTRODUCTION: Family physicians are the cornerstone of primary health care in Canada. Yet, retention remains a growing concern. Challenges in retaining family physicians poses serious implications for healthcare accessibility, continuity, and equity across all practice contexts in Canada, including (but not limited to) rural, remote, urban, and underserved communities. Currently, 25% of Canadians do not have a primary care provider. While much attention has been given to recruitment, less is known about the multifaceted and intersecting factors that influence whether practicing family physicians and family medicine trainees (including Canadian Medical Graduates (CMGs) and International Medical Graduates (IMGs)), remain in sustained comprehensive practice in Canada. This review synthesizes the literature to identify key drivers of family physician retention and offers evidence-based recommendations. METHODS: We conducted an integrative review of peer-reviewed literature published between January 1, 2000, and March 30, 2025, following Whittemore and Knafl’s five-stage methodology. A systematic search was carried out across five electronic databases. Included studies were assessed for quality and thematically analyzed using a five-domain coding framework: personal, family, community, professional, and structural/systemic. Composite personas were developed to illustrate recurring physician retention trajectories and evidence-based recommendations were thematized across our five-domain coding framework. RESULTS: Of the 1,613 records screened, 23 studies met inclusion criteria. Factors influencing retention were identified across all five domains. Structural and professional barriers, including licensure restrictions, administrative burden, and limited autonomy, emerged as the most consistent deterrents. Facilitators included strong community ties, spousal support, team-based practice environments, and access to continuing professional development. We identified and developed seven physician personas to create a portrait of the diverse experiences of family physicians in Canada. Key recommendations included reforming licensure and payment models, enhancing mentorship and CME access, supporting spousal integration, and fostering culturally safe, community-rooted team-based practice models. CONCLUSION: Retaining family physicians in Canada is a relational challenge that requires collaborative, multi-level change. Tailored, context-specific retention strategies co-designed with physicians and communities can enhance sustainability and health equity especially in rural, remote and underserved communities.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».