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PUPPY Study – Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year: A Longitudinal Mixed Methods Study with Rapid Reporting and Planning for the Road Ahead

Researcher bios and how their research backgrounds relate to this study

Dr. Mathews is a primary care, health services researcher located at the Centre for Studies in Family Medicine, Western University, London Ontario. This is a primary care research project looking at experiences of patients looking for a regular family physician using the Health Care Connect waiting list. There will also be interviews with family physicians/Nurse Practitioners, policy makers and pharmacists regarding their experiences with 'unattached' patients.

Purpose of this research project

Purpose: To rapidly identify and evaluate strategies to provide primary care access and COVID-19 care and triage by family physicians, nurse practitioners and pharmacists that can be scaled-up to promote attachment and improved access for patients now, and in future COVID-19 waves, with a particular focus on unattached and vulnerable populations, reducing the burden on acute care sectors.

This project includes health administration data, surveys and interviews with relevant stakeholders.  The aspect of this project we would like to have shared with your group is the in depth interviews regarding patient experiences of being ‘unattached’ (no regular primary care provider) in general but also with an emphasis on during the pandemic.

Abstract: The majority of health care visits are to primary care providers such as family physicians, nurse practitioners, and pharmacists. These individuals make up the core care team for most people. They normally help coordinate and manage health care. COVID-19 has caused significant changes in primary care. In Canada, many walk-in clinics and family practices have closed. Pharmacies remain open but with restrictions on patient interactions.

Other major changes in care (e.g., virtual care, reduced referrals) have been made to respect public health and emergency orders. During these times with significant restrictions, patients can be unclear or unaware of how to get the right care, at the right time, from the right provider. Patients also fear getting COVID-19 and avoid care settings. Some will also avoid seeking care for COVID-like symptoms due to fear and a lack of access to a primary care provider.
Understanding the rapid changes in primary care and how to navigate these is challenging for everyone, but more so for people without a regular primary care provider to help guide them. This is especially true for vulnerable groups (e.g., those with serious mental illness) and those with chronic health conditions that require ongoing, frequent care (e.g., bloodwork, scans, medication changes). COVID-19-related disruptions may lead to significant delays in treatments or unmet health care needs for many people. This may negatively affect population health outcomes and increase costs to health and social systems. The proposed study builds on existing research with an experienced team. The team will work to understand critical gaps in primary care access and coordination by comparing data from before, during, and after the pandemic. Multiple sources of data will be used such as policy makers, primary care providers, patients, waitlist data, healthcare billings, and prescribing data. The results are critical for strengthening primary care during and beyond the COVID-19 pandemic.

How this research will help LGBT2SQ people and communities

We want to identify groups who have difficulty accessing a family physician and understand patients experiences of using the Health Care Connect system including LGBT2SQ patients.


English speaking adults (18+) who have used Health Care Connect to be matched to a family physician or are currently on the Health Care Connect waiting list.


$75 eGift card for patient participants

Mitigation measures

Interviews are unlikely to cause distress. We provide contact information for helpline should anyone need it.

Promoting the Study

Through social media. Ethics approved wording is below and the ask would be to share this with your network if appropriate: “Are you a patient in Ontario, Canada without a family doctor on the Health Care Connect waiting list? Have you been assigned a family doctor through Health Care Connect? Researchers @WesternuFamMed are interested in talking to you. Please contact if you are interested in sharing your experiences.”

If sharing on Twitter, it is a slightly shortened message:
Are you a patient in Ontario without a family doctor on the Health Care Connect waiting list? Were you assigned a family doctor through Health Care Connect? Researchers @WesternuFamMed are interested in talking to you. Contact to share your experiences.

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