Objective: To identify trends in family practice in London, Ont, between 1974 and 1994.
Design: Interview survey of all London family physicians in 1974. Questionnaire surveys in 1984 and 1994.
Setting: City of London, Ont.
Participants: One hundred twenty-eight family physicians and general practitioners practising in London in 1974, 180 in 1984, and 237 in 1994.
Results: The percentage of female practitioners, practitioners with no in-hospital patients, and practitioners making no home visits in an average week increased significantly. The percentage of solo practitioners and family physicians practising obstetrics decreased significantly. Changes were found in the numbers of patients seen, in weekend coverage, in evening, and Wednesday afternoon office hours, and in level of satisfaction with practice.
Conclusion: Fewer physicians cared for in-hospital patients, made home visits, practised solo, and delivered babies in 1994 than in 1974. Substantially more women were practising family medicine in 1994 than in 1974. The trend away from in-hospital care, with no corresponding increase in home care, raises questions about how urban family physicians can maintain certain clinical skills.