Predicting factors for accepting new patients into primary practices by Ontario physicians

Purpose Many issues surround primary care physician shortages in Ontario and the openness of their practices. My thesis reviews these issues as reflected in the literature and investigates the factors that influence the physician behaviour involved in accepting or not accepting new patients. Thus, my thesis will contribute to current knowledge for improving access to family doctors in Ontario and provide recommendations for future health care reform. I propose that the issue of accepting new patients is a result of an interaction between the physician (person) and the physician's environment (place). My hypothesis is that both person factors of the physician (e.g. sex) and place factors (e.g. type of practice) will affect whether primary care physicians will accept patients into their practices in Ontario.;Methods My study employed a secondary data analysis of the 2007 Annual Membership Renewal Survey of the College of Physicians and Surgeons of Ontario. The study population was selected from the 22,668 physicians who responded this 2007 survey. The inclusion criteria for the study were: (i) physicians who were certified by the College of Family Physicians of Canada (CFPC) or general practitioners who were neither certified by the CFPC nor by the Royal College of Physicians and Surgeons of Canada (RCPSC) and, (ii) physicians who indicated on their survey that they spend a minimum of 41% of their clinical time in family practice. Logistic regression was used to determine if, and in what way, independent person and place variables influenced physicians to accept new patients.;Results Eleven percent (11.4%) of primary care physicians were accepting new patients, which was significantly influenced by age (youngest physicians OR=1.85, p<0.001), sex (males OR=1.55, p<0.001), international medical graduates (OR=2.43, p<0.001), practice location in rural northern Ontario (OR=4.81, p<0.001) and administrative groups (OR=0.522, p<0.001) in the full model (R2=0.087). The data analysis supported the hypothesis that both person and place characteristics influenced the behaviour of accepting new patients.;Conclusions The behaviour of accepting new patients is complex for primary care physicians. Knowing which primary care physicians will accept new patients will help policy makers to focus efforts on those who are less likely to open their practices in order to meet the demands of Ontario's population.