Primary care

Family physicians are the backbone of the health system

Family physicians are the backbone of our primary care system: They run their own local practices, work in nearby hospitals and emergency rooms, and tend to those in long-term care homes.

Having a regular family physician improves health outcomes, reduces mortality, decreases hospitalizations, and reduces health care costs. Our health care system is feeling the impact of a family doctor shortage, which is worsening as more doctors retire and fewer medical school graduates enter this profession. Between seeing patients, administrative tasks, leadership roles, and paperwork, family physicians are overburdened and burnt out.

We need systemic change to support family physicians to be leaders of health care teams and to practice comprehensive, team-based care. Physician-led team-based care includes nurse practitioners and physician assistants, but also family practice nurses, high functioning medical office assistants, therapists and specialized technicians. Clinical teams will look different depending on the specific needs of the community it is serving.

What is the solution?

The Patient’s Medical Home (PMH) is a way of providing care that gives patients access to a variety of health care professionals including doctors, nurse practitioners and social workers. The health care team works together to get patients more services sooner, with medical records following patients within the team, and with connections to other parts of the health care system that are faster and easier.

How would my experience in a PMH clinic be different?

The document in the link below discusses how a patient experience is different in a Patient’s Medical Home clinic:


Click on the link below to find out more about the PMH:

Aren’t Health Networks the PMH?

  1. The Patient’s Medical Home (PMH) is the heart of every high-functioning Health Network.

  2. Health Networks and Patient’s Medical Home are not the same but are designed to work together. The Patient’s Medical Home provides seamless care that is centred on individual patients’ needs, within their community, throughout every stage of life, and integrated with other health services. It’s based on comprehensive team‐based care with family physician leadership.

  3. The PMH exists within, and is supported by, the larger, surrounding Health Network.

  4. Multiple PMHs will exist within any Health Network.

  5. We need to support family physicians to start working in a PMH, within their network. Currently some family physicians have access to allied health care teams, but many do not and are practising without the support of a PMH.

  6. A Patient’s Medical Home is also more than just a team, it’s appropriate infrastructure in clinics, it’s continuity of care, it’s appropriate funding and support. These foundational supports will help physicians provide timely, accessible, comprehensive, patient-centred care.

News and Resources


Despite some improvements, reports published in recent years suggest primary care in Quebec performs poorly compared to other Canadian provinces in terms of accessibility and coordination. Quebec’s primary-care system is mainly based on the Family Medicine Group (FMG) model, in which patients are registered with a family physician who works with a team of other health-care professionals, such as nurses, social workers and pharmacists. FMGs were introduced in 2002 in response to challenges faced by the community-based CLSC model, including a lack of integration with the broader health-care system and difficulties in attracting and retaining family physicians. Today, 65 per cent of the population is registered with a family physician working in an FMG.

Ontario College of Family Physicians

By 2025, one-in-five Ontarians may not have a family doctor. However, the impact of the rising number of unattached patients is already being felt today. We are seeing overflowing emergency rooms, hearing from concerned health professionals and Ontarians and watching the rising cost of healthcare. A multipronged approach is needed to ensure that every Ontarian can have timely access to a family doctor, particularly populations facing disproportionate challenges accessing primary care. The government’s commitments to opening more family medicine residency training spots and streamlining licensing for internationally trained physicians are welcome steps, but more is needed now. With dedicated funding and appropriate accountability, we can build a more equitable and efficient healthcare system.

StarPhoenix, May 9, 2023

News of incoming payment reforms for Saskatchewan family doctors has many hopeful that patients will soon receive a more holistic and preventative approach to health care. “It’s something we’ve been advocating for for a while, both nationally and in Saskatchewan,” said Dr. Brady Bouchard, a family practitioner in North Battleford and member of the SMA Board of Directors.

Temerty Faculty of Medicine, University of Toronto, April 11, 2023

“Can you help me find a family doctor?” As Chair of the Department of Family and Community Medicine (DFCM) at the University of Toronto, I am asked this question nearly every day. All around us, people have lost access to the entranceway to our health system – and are wondering what to do about it. If it feels like primary care in Canada is in crisis, that’s because it is.

Global News Saskatoon,  March 31, 2023

The government of Saskatchewan is offering more money to physicians and clinics to entice them to stay open after hours. Funding is being made available to after-hours urgent care and walk-in care with the aim of trying to improve patient access to family doctors after an agreement in principle between the province and the Saskatchewan Medical Association.

650 CKOM, March 31, 2023

In an effort to improve access to care in Saskatchewan for patients seeking help from a family doctor, the province is offering better compensation to physicians to incentivize extended hours. On Friday, the Saskatchewan government and the Saskatchewan Medical Association (SMA) made the announcement about the new funding, though no specific dollar amount was attached.

CTV News Saskatchewan, March 31, 2023

The Saskatchewan government will offer a bump in pay to encourage family doctors to work later hours. On Friday, the provincial government announced an agreement with the Saskatchewan Medical Association (SMA) to pay fee-for-service family doctors an extra $8 to $12 per visit if they’re seeing a patient after-hours. The province hopes the move might take some of the pressure off Saskatchewan’s emergency rooms.

CBC Saskatchewan, March 31, 2023

Saskatchewan’s health minister says a move to increase compensation for family doctors offering after-hours care will help people get access to physicians while the province continues to deliberate how to reform a payment model. On Friday, the province announced an agreement in principle with the Saskatchewan Medical Association that will see additional funding available to eligible after-hours urgent care and walk-in clinics.

StarPhoenix, March 31, 2023

Increased funding for after-hours care and walk-in clinics is a positive step toward improving health-care access for patients, the Saskatchewan Medical Association president says. The provincial government and SMA announced Friday an agreement in principle had been reached on enhancements to physician compensation that they hope will increase patient access to family doctors and ease stress on emergency rooms in Saskatchewan.

Toronto Star, March 25, 2023

Saskatchewan family doctors say the province’s latest budget fails to make needed reforms that would help keep them here as some look elsewhere for work. Saskatchewan Medical Association President Dr. John Gjevre said the Saskatchewan Party government’s budget doesn’t do enough to transform primary care so that more people can access a family doctor.

Prince Albert Daily Herald, March 17, 2023

The president of the Saskatchewan Medical Association (SMA) said he’s pleased to see the provincial government increase the amount doctors receive from the Rural Physician Incentive Program, but added that it’s just one of many things needed to keep doctors in Saskatchewan.

CBC, March 19, 2023

Dr. Sean Groves has seen first-hand the difficulties of keeping physicians in northern Saskatchewan. The Saskatoon native has worked at the La Ronge Medical Clinic for 17 years. His favourite parts of being a rural doctor are being able to develop close relationships with patients and the variety of work he gets to do. But working as a physician in rural and northern Saskatchewan isn’t for everyone. 

CTV News Saskatoon, March 2, 2023

“We believe every person deserves access to high-quality primary health care. We believe everyone who wants access to a ‘medical home’ — a team of primary health care professionals working together and led by a family physician — should have it,” said Saskatchewan Medical Association president Dr. John Gjevre and Saskatchewan College of Family Physicians president Dr. Andries Muller in a joint statement shared with media.

CBC News Saskatchewan, March 2, 2023

Dr. Andries Muller, president of Saskatchewan’s College of Family Doctors, says about one in six Saskatchewan residents currently don’t have a family doctor, which is leading to longer wait times in the province’s emergency rooms and walk-in clinics. He would like to see a significant portion of the federal funding go toward restructuring the way primary care is delivered in the province.

By Dr. Trevor Theman: Edmonton Journal, Feb. 9, 2023

Broad consensus says that Canada’s health care system is in crisis and major reform is needed, and that part of that reform is to ensure that every Canadian has access to a family doctor. I agree that our health care system is in crisis and that the major reform must be in primary care, to ensure that every person has access to a “medical home,” a team of primary-care professionals working together to deliver high-quality, patient-centric and comprehensive patient care.

By Dr. Tara Kiran: Globe and Mail, Feb. 7, 2023

Access to health care should be based on need and not on one’s ability to pay. Time and again, people in Canada have reaffirmed this as a fundamental value we share.

CBC audio – The Current with Matt Galloway: Feb. 7, 2023

Millions of Canadians don’t have a family physician or any primary care provider. People spend months searching for care, often without success. Many turn to walk-in clinics, virtual care and emergency rooms to get the help they need. These problems are felt across the country, but the shortage is particularly acute in Victoria, B.C. The Current’s Matt Galloway hosted a public forum there to hear from the people affected, and explore the solutions that could help all Canadians.


Just-released data suggests that more than 6.5 million Canadian adults are without a primary care provider, whether family doctor or nurse practitioner. Imagine for a second if one-in-six Canadian families couldn’t enrol their children in their local public school. Outrageous. Unthinkable. Unacceptable.

By Richard H. Glazier: Canadian Family Physician, January 2023

Before considering the problems and potential solutions facing Canadian primary care and the Canadian health care system, it is important to consider our values and the health system we aspire to have. The Quintuple Aim and the Patient’s Medical Home are relevant frameworks, identifying key goals and functions of health care systems and primary care. 

Source: Government of Alberta

The Modernizing Alberta’s Primary Health Care System initiative has been established to strengthen primary health care in Alberta and ensure all Albertans have access to timely, appropriate primary health care services. Primary health care is the first point of contact Albertans have with the health system, and includes health professionals such as family doctors, nurse practitioners, pharmacists and public health nurses. This work will engage Alberta primary health care leaders, along with national and global experts, to identify immediate and long-term improvements that can build on the many primary health care successes in Alberta.

Postmedia podcast: Nov. 8, 2022

B.C.’s government has made major changes to the way family doctors are paid, with the hope of attracting and retaining medical professionals in that province. But will it help attract enough talent to address severe waits to see a GP in B.C.?

Source: Doctors Manitoba

There are 1.4 million people in Manitoba. There are 3,100 physicians. We are working hard every day to keep Manitobans healthy and to help you and your loved ones get the care you need.

Source: Doctors of BC

Physicians who provide longitudinal patient care are the foundation of our primary care system, yet nearly one million British Columbians do not have access to a family doctor. Doctors of BC is strongly advocating on behalf of the profession and patients to address the significant challenges that have created the shortage of family physicians. This webpage includes up-to-date information on the changing primary care environment.