Facilitators, barriers, and priorities for enhancing primary care recruitment and retention in Saskatchewan, Canada
Udoka Okpalauwaekwe, Brian K. MacPhee, Lindsay Balezantis, Akram Khayatzadeh‐Mahani, Amy Zarzeczny, Vivian R. Ramsden, Angela Baerwald, Align Primary Care Working Group Members, Brenda Andreas, Erin Brady, Jessica T. Campbell, Selene Daniel-Whyte, Coralie Darcis, Diana Ermel, Fei Ge, John Gordon, Jackie Hanson, Carla Holinaty, Jason Hosain, Max Karnitsky, Melissa Kimens, Matthew Kushneriuk, Kathy Lawrence, Bryan MacLean, Cathy MacLean, Veronica McKinney, Andries Muller, Cassandra Opikokew-Wajuntah, Meriç Osman, Olivia Reis, Johann Roodt, Ginger Ruddy, Sheila Smith, Kent Stobart, Stuart R. Stone, Janet Tootoosis, Felicia Watson, Jon Witt, Matthew C. Wong, Julie Yu
Abstract
BACKGROUND: Saskatchewan (SK), home to 1.2 million Canadians, faces a high prevalence of chronic illnesses and a shortage of primary care providers (PCPs), resulting in significant challenges in providing access to care. This situation necessitated the co-creation of evidence-informed strategies for recruiting and retaining PCPs to optimize health outcomes in the province. METHODS: Using an integrated framework of transdisciplinarity and participatory research, we explored facilitators and barriers to strengthening primary care in Saskatchewan, with a focus on family physicians. A modified World Café forum engaged a diverse group of partners, including patient partners, medical trainees, Residents, PCPs, researchers, and policymakers. Participants discussed facilitators and barriers to PCP recruitment and retention, as well as the priorities for improving primary care delivery. RESULTS: Key facilitators identified included, targeted recruitment efforts for family medicine, supportive professional incentives, and policy reforms in compensation models. Key barriers included knowledge gaps in retention strategy evaluation, unsustainable recruitment-retention programs, undervaluing of family medicine in academia, community-physician disconnect, physician burnout, negative media influences, harsh weather, systemic racism, inadequate mentoring of medical trainees, and a lack of recognition for PCPs. Priority actions to bridge these gaps included, strengthening primary care research with engagement of patient partners and communities, health system advocacy coordination, PCP support through benefits and pensions, implementing team-based primary care, and enhancing medical education, training efforts and mentorship. CONCLUSION: This World Café study identified valuable insights for enhancing primary care through recruitment and retention of family physicians in Saskatchewan, which included continuing primary care research, community engagement, and co-creating policy that facilitate equitable access to quality healthcare across the province. We believe these findings model effective strategies for optimizing primary care delivery across Canada as well.