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Take a closer look at health workforce data, including historical trends.

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• Over the past decade, the number of family physicians in direct care roles increased by nearly 20% (from 29,341 in 2014 to 35,244 in 2022) in Canada, while the average growth in the overall number of family physicians slowed substantially (from 2.7% between 2015 and 2017 to 1% between 2021 and 2023). In parallel, the average FTE (full-time equivalent) per family physician remained stable, suggesting that family physicians continued to work at a similar capacity.
  • The increase in the number of family physicians has just kept up with population growth, as the number of family physicians in direct care per 10,000 population only increased from 10.8 to 11.7 over the same period.
  • The longer-term trend of family physicians seeing fewer patients on average has continued (from 1,746.1 in 2013 to 1,429.6 in 2022 — an 18.1% decline). Many factors contribute to this trend. These factors may include an aging and increasingly complex patient population, which requires more time per patient; the increase in team-based care, where patients see other members of the care team (e.g., nurse practitioners [NPs]); changes in practice patterns, including pharmacist prescribing; reductions in patient load to maintain provider well-being; regulatory and reimbursement model changes; and administrative responsibilities, sometimes as a result of shortages of other team members. Further data and analyses on the number of patients seen by other non–family physician primary care providers is required to understand the net effect on primary care access.
• While most family physicians work in primary care, the network of health care providers delivering primary care is expanding. In 2023, other than family physicians, the in-scope professionals with the highest proportions working primarily in community settings, such as primary care, were pharmacists (73.3%) and physiotherapists (69.9%) at nearly three-quarters of their workforces. While these findings may suggest increased availability of providers for primary care, further data is needed to assess the impact on access to care. Additional findings include
  • The proportion of physiotherapists primarily working in these settings increased by more than 15 percentage points over the past 10 years, the largest growth observed.
  • Registered nurses (RNs) (n = 36,945) and licensed practical nurses (LPNs) (n = 18,847) had the largest number of professionals primarily working in these settings.
  • Almost 1 in 3 (n = 2,151) NPs primarily worked in these settings, a 3-percentage-point increase over the past 10 years.
• Emerging data suggests that the uptake of minor ailment prescribing by pharmacists varies by minor ailment and jurisdiction. The largest uptake has been for cold sores (herpes labialis), pink eye (conjunctivitis) and uncomplicated urinary tract infections (UTIs). The uptake of pharmacist prescribing programs may suggest improved access to primary care for patients. There is a need to continue monitoring these trends to gain a better understanding. More data is needed to measure the impact of pharmacist prescribing programs on improving access to primary care for patients and reducing family physician workload.

These results are based on data available at the time of publication. Many results are presented at the pan-Canadian level; trends may vary at the provincial/territorial and regional levels. Data to explore these trends is available in the Download the data section of this report.

While it is assumed that most family physicians work in primary care, the health care professionals included in this report may be providing care in settings including but not limited to primary care. Data limitations prevent us from reporting results for practitioners who work exclusively in primary care and from identifying those who work in multiple settings. When feasible, data on providers who are employed primarily in community settings (e.g., primary care, private practice) is presented. Gaps, including coverage differences across professionals and jurisdictions, are acknowledged throughout the report. These limitations should be considered when interpreting the findings.

Provincial and territorial governments have been working to address the strain on Canada’s health care systems through new health service funding agreements, digital health strategies like virtual care and telehealth, and workforce policy changes. Many of these policies are increasingly focused on expanding provider roles to meet rising primary care demand and tackle recruitment and retention challenges. Examples of policy changesReference5 between 2022 and 2023 include the following:

• Most jurisdictions continue to expand NPs’ and pharmacists’ prescribing authority to treat minor ailments independently. Newfoundland and Labrador, Ontario and British Columbia have also granted RNs prescribing powers with accompanying training programs. Additionally, Ontario has approved regulations expanding LPNs’ scope of practice, allowing them to independently perform certain controlled acts in specific settings without needing an order from an authorized health care professional.
• Some jurisdictions (Quebec, Ontario and Saskatchewan) have established new NP-led clinics in areas with limited access to family physicians. In addition, most jurisdictions are investing in emergency medical services (EMS) and the expansion of community paramedicine services. These initiatives aim to improve access to primary care, reduce the number of patients without a regular health care provider and alleviate workload pressures on family physicians.
• To bolster health workforce recruitment and retention, many jurisdictions have increased funding for professional education and implemented various incentives. These include streamlined licensing, new graduate recruitment, signing bonuses and return-in-service agreements, international recruitment, bridging programs for internationally educated nurses and interjurisdictional mobility for selected health professionals. Additionally, jurisdictions have expanded funding for training facilities and programs to increase educational capacity and enhance nursing skills and competencies for more specialized roles. 

The trends in this report shed light on the state of the health workforce that may be engaged in primary care. Additional data and further examination of these trends at more local levels (e.g., provincial/territorial, regional, care settings) are needed to support informed planning, strategies and evidence-based decisions for a primary care workforce that meets the needs of the population in Canada.

Key to this will be

• Standardized and linkable data within and across professions, along with comparable metrics to address data gaps and to further explore variations within and across professions, jurisdictions and care settings
• Strengthening data to better understand the increasing demand for primary care and the complexity of patient health care needs, including the consideration of Canada’s changing demographics, such as record-setting population growth along with an aging population, and the impact of these changes on health needs and demands
• Understanding the evolving primary care environment (e.g., multidisciplinary teams, expanding scopes of practice, new funding and care models) and its impact on health care providers, access to care and patient outcomes