Surge capacity and practice management challenges of Canadian family physicians during COVID-19: a qualitative study

Abstract Background Planning for surge capacity, that is, the ability of a health service to expand beyond normal capacity and meet an increased demand for clinical care, is an essential component of public health emergency preparedness. During the COVID-19 pandemic, family physicians (FPs) were cal...

Full description

Saved in:
Bibliographic Details
Main Authors: Maria Mathews, Dana Ryan, Lindsay Hedden, Julia Lukewich, Emily Gard Marshall, Paul Gill, Stephen J. Wetmore, Leslie Meredith, Sarah Spencer, Judith Belle Brown, Thomas R. Freeman
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Human Resources for Health
Subjects:
Online Access:https://doi.org/10.1186/s12960-025-00981-w
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Planning for surge capacity, that is, the ability of a health service to expand beyond normal capacity and meet an increased demand for clinical care, is an essential component of public health emergency preparedness. During the COVID-19 pandemic, family physicians (FPs) were called upon to provide surge capacity in settings such as hospital units and emergency departments while also maintaining their primary care responsibilities. Most research reports on projection models, hospital settings, or the use of virtual care, with limited focus on the firsthand experiences of FPs in this role. To address this gap, this study examines the experiences of FPs and their roles in supporting surge capacity during the COVID-19 pandemic. Methods As part of a mixed methods, multiple case study, we conducted semi-structured interviews with FPs between October 2020 and June 2021 across four Canadian provinces (British Columbia, Ontario, Nova Scotia, Newfoundland and Labrador). During the interviews, FPs were asked about the roles they assumed during the different stages of the pandemic and the factors that impacted their ability to fulfil these roles. Interviews were transcribed verbatim and a thematic analysis approach was employed to identify recurring themes. Results We interviewed a total of 68 FPs across the four provinces and identified two overarching themes: (1) mechanisms used to create surge capacity by FPs, and (2) key considerations for an organized surge capacity program. During the pandemic, surge capacity was achieved by extending FP working hours, expanding the FP workforce, and redeploying FPs to new roles and settings. The effective implementation of FP surge capacity requires organized communication and coordination mechanisms, policies to clarify scope of practice during redeployment, training and mentorship related to new redeployment roles, FPs holding hospital privileges, and policies that help to preserve primary care capacity. Conclusions FPs make critical contributions to surge capacity but require structured support to balance their redeployment roles with their ongoing primary care responsibilities. Ensuring adequate coverage for their practices and employing strong communication and coordination mechanisms are essential for maintaining high-quality care and managing the strain on FPs and the health system during public health emergencies.
ISSN:1478-4491