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This multi-phase project investigates the work family physicians do outside of direct patient care, such as managing electronic inboxes and coordinating referrals.

In Phase 1, we completed two systematic reviews on these topics.

Phase 2 has two parts. In Part 1, we reviewed 137 referral forms from 5 provinces to see how well they follow provincial guidelines. Our paper, “Examining the Policy Compliance of Canadian Referral Forms,” is under review at Healthcare Policy. A related paper, “Characterizing How Sex and Gender Information Is Solicited via Canadian Medical Referral Forms,” has been submitted to Health Services Research and Policy. In Part 2, we are recruiting family physicians to record themselves as they “think aloud” while managing their electronic inboxes. So far, we have recordings from 23 physicians in Ontario, Newfoundland and Labrador, British Columbia, Alberta, and Manitoba. We are analyzing this data to describe the range of tasks involved, identify complicating factors, and highlight the knowledge and skills needed to do this work effectively.

Phase 3 has just received ethics approval and will begin soon! We will interview family physicians, residents, and specialists to learn about their experiences with indirect patient care activities and resulting decisions they make.

Project lead and contact: Meredith Vanstone (vanstomg@mcmaster.ca)