Joshi Atharv, Brown Judith Belle, Savundranayagam Marie, Sibbald Shannon L
Faculty of Health Sciences, Western University, London, ON, Canada.
Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 2K5, Canada.
BMC Prim Care. 2025 Apr 9;26(1):102. doi: 10.1186/s12875-025-02808-y.
Physician engagement is critical to the success of primary care transformation, yet strategies to support meaningful engagement remain understudied. Despite existing research, gaps persist in understanding how physician engagement unfolds within system-level initiatives in primary care. This paper examines physician engagement through the development of the London Middlesex Primary Care Alliance (LMPCA), a regional initiative uniting primary care providers in Southwestern Ontario to advocate for system improvements and support health system transformation, including the Middlesex-London Ontario Health Team (ML-OHT). Rather than centering solely on physician perspectives, our study explores physician engagement as part of a broader collaborative effort involving healthcare administrators and support personnel. Data were collected through interviews (n = 13; including primary care physicians, healthcare administrators, and administrative support personnel), document analysis, and an environmental scan. Findings highlight the importance of grassroots leadership, governance structures, and system-level supports in driving physician engagement. The role of a primary care transformation lead emerged as a key facilitator, while lack of compensation for system-level work remained a barrier. This study provides insights into the formation of a sustainable, self-governing primary care organization and offers considerations for scaling engagement strategies while mitigating burnout and ensuring long-term participation.
医生的参与对于初级保健转型的成功至关重要，但支持有意义参与的策略仍未得到充分研究。尽管已有相关研究，但在理解医生参与如何在初级保健的系统层面举措中展开方面，仍存在差距。本文通过伦敦米德尔塞克斯初级保健联盟（LMPCA）的发展来审视医生的参与情况，LMPCA是一项区域性举措，联合了安大略省西南部的初级保健提供者，以倡导系统改进并支持卫生系统转型，包括米德尔塞克斯 - 伦敦安大略省卫生团队（ML - OHT）。我们的研究并非仅以医生的视角为中心，而是将医生的参与视为涉及医疗保健管理人员和支持人员的更广泛协作努力的一部分。通过访谈（n = 13；包括初级保健医生、医疗保健管理人员和行政支持人员）、文件分析和环境扫描收集数据。研究结果强调了基层领导、治理结构和系统层面支持在推动医生参与方面的重要性。初级保健转型负责人的角色成为关键促进因素，而系统层面工作缺乏报酬仍然是一个障碍。本研究为可持续的、自我管理的初级保健组织的形成提供了见解，并为扩大参与策略、减轻倦怠和确保长期参与提供了思考。
