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Original Research

'Rural' doesn’t mean 'uniform': northern vs southern rural family physicians' workload and practice structures in Ontario

Submitted: 26 June 2013
Revised: 5 November 2013
Accepted: 5 November 2013
Published: 24 June 2014

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Author(s) : Wenghofer EF, Timony PE, Gauthier NJ.

Elizabeth WenghoferPatrick TimonyNicole Gauthier

Citation: Wenghofer EF, Timony PE, Gauthier NJ.  'Rural' doesn’t mean 'uniform': northern vs southern rural family physicians' workload and practice structures in Ontario. Rural and Remote Health (Internet) 2014; 14: 2720. Available: (Accessed 20 October 2017)


Introduction:  There is a tendency in health policy in Ontario, Canada, to conflate ‘northern’ with ‘rural’ and to equate northern rural settings with southern ones. Although previous research has identified some differences between rural and urban practitioners, these studies have not acknowledged the subtle nuances that make rural practice different in the north than in the south. This study looks more closely at practice patterns and compares number of hours worked per week, patient volume and practice type for rural northern, rural southern, urban northern and urban southern physicians.
Methods:  This study utilized data from Ontario’s medical regulatory authority’s 2007 annual membership renewal survey. Descriptive statistics and χ2 analyses were used to examine practice type (eg solo, clinical group), hours worked per week and number of patient visits per week for 10 968 primary care physicians in Ontario’s rural north, rural south, urban north and urban south.
Results:  Three key results emerged from the analyses: (1) physicians in rural northern Ontario worked more hours per week than their counterparts in other regions of the province, yet (2) they saw fewer patients per week, and (3) worked more frequently in clinical group-based practices.
Conclusions:  Rural northern physicians with different practice structures, different patient types, broader scope of services, and different encounter lengths indicate variations specific to locations and populations and communities. The interaction between the rural and northern context is unique and as such a blanket ‘rural’ or ‘northern’ approach to policy development is likely to be ineffective.

Key words: general practitioners, north–south differences, Ontario physicians, practice patterns, rural–urban differences.

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