How early-career family physicians integrate social accountability into practice: Findings from a multijurisdictional qualitative study.

OBJECTIVE

To explore how early-career family physicians integrated social accountability into their practices, how it shaped their practice choices, and the challenges they encountered.

DESIGN

A secondary analysis of qualitative interview data.

SETTING

British Columbia, Ontario, and Nova Scotia.

PARTICIPANTS

Early-career family physicians.

METHODS

Initially a deductive analysis was conducted using a framework for categorizing 3 different levels of social accountability (individual patient [micro], community [meso], and system [macro]). An inductive analysis was then undertaken to explore how social accountability informs practice choice and to understand challenges encountered. A reflexive thematic analysis guided the inductive process.

MAIN FINDINGS

Social accountability was most commonly discussed at individual and community levels, with more limited system-level examples. Many early-career family physicians valued providing holistic care and derived professional satisfaction from meeting patient and community needs. These values, which are consistent with social accountability, informed their choice to pursue medicine and family medicine specifically. Available practice and payment models were described as barriers to socially accountable practice. Participants believed they lacked the knowledge, skills, and power to influence policy.

CONCLUSION

There is a need to support practice environments that are conducive to socially accountable practice and for curricula that can provide physicians with tools to engage with community- and system-level policy issues.