CHANGING FACE OF FAMILY-PRACTICE - TRENDS FROM 1974 TO 1994 IN ONE CANADIAN CITY

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.