OBJECTIVE To identify trends in family practice in London, Ont, betwee
n 1974 and 1994. DESIGN Interview survey of all London family physicia
ns in 1974. Questionnaire surveys in 1984 and 1994. SETTING City of Lo
ndon, 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, practitio
ners with no in-hospital patients, and practitioners making no home vi
sits in an average week increased significantly. The percentage of sol
o 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 c
ared for in-hospital patients, made home visits, practised solo, and d
elivered babies in 1994 than in 1974. Substantially more women were pr
actising family medicine in 1994 than in 1974. The trend away from in-
hospital care, with no corresponding increase in home care, raises que
stions about how urban family physicians can maintain certain clinical
skills.