Strengthening the integration of primary care in pandemic response plans: A qualitative interview study of Canadian family physicians

Background: As the first point of contact in healthcare, primary care providers play an integral role in pandemic response. Despite this, primary care has been overlooked in previous pandemic plans, with a lack of emphasis on ways in which the unique characteristics of family practice could be leveraged to create a more effective response. Aim: To explore family physicians’ perceptions of the integration of primary care in the COVID19 pandemic response. Design and Setting: Descriptive qualitative approach examining family physician roles during the COVID19 pandemic across four regions in Canada. Method: We conducted semi-structured qualitative interviews with family physicians and asked about their roles during each pandemic stage, as well as facilitators and barriers they experienced in performing these roles. Interviews were transcribed and a thematic analysis approach was employed to develop a unified coding template across the four regions and identify recurring themes. Results: Sixty-eight family physicians completed interviews. Four priorities for integrating primary care in future pandemic planning were identified: 1) improve communication with family physicians, 2) prioritize community-based primary care, 3) leverage the longitudinal relationship between patients and family physicians, and 4) preserve primary care workforce capacity. Across all regions, family physicians felt that primary care was not well-incorporated into the COVID19 pandemic response. Conclusion: Future pandemic plans require greater integration of primary care to ensure the delivery of an effective and coordinated pandemic response. Strengthening pandemic preparedness requires a broader reconsideration and better understanding of the central role of primary care in health system functioning.