Should I stay or should I go? Explaining general practitioners’ decision to quit new primary care team in Quebec, Canada

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Speaker: Mehdi Ammi

Date/Time: September 16, 10 AM – 12 PM

Location: Health Sciences Building (155 College Street, Toronto ON), Room HS 100


In this paper, we examine the factors explaining general practitioners’ (GPs) decision to leave inter-professional primary care teams, a model of health care delivery increasingly used in developed countries. To do so, we use five years of administrative panel data for all the GPs who joined a Family Medicine Group (FMG) in Quebec between 2003 and 2005. In FMGs, GPs are paid fee-for-service, while the Health Ministry pays nurses’ salaries in exchange for extended access hours. About 17% of GPs leave these organizations within five years of follow-up. We use fixed-effects and random-effects logit and show that physicians with more complex patients are less likely to leave FMGs. So do GPs with higher income. Our findings are robust across different subsamples. Of notice, we show the reliability of a causal interpretation of the effect of patient complexity on the decision to leave using one lag in the regressions, focusing on a matched sample and examining the impact of quitting on patient caseload. Our results thus suggest that inter-professional primary care teams may provide appropriate support to physicians dealing with complex patients.




Mehdi Ammi, Ph.D., is Assistant Professor in Economics in the School of Public Policy and Administration at Carleton University. His primary research interests are in health economics and in applied microeconometrics. His research focuses on physician behaviour, quality of care, and utilization of health care services. He uses large administrative database and stated preferences techniques with the view to analyze how health policy changes impacts individual behaviour.