UCalgary study offers new insight into physician shortage in Alberta

Researchers analyzed 16 years of data and reveal changes driving many of today’s challenges.

Kelly Johnston, Cumming School of Medicine, University of Calgary September 23, 2025

There is a growing population of aging Albertans. That’s likely not a surprise to most. What might be is the trickle-down effect the growing population of older people, and an increasing number of people with chronic conditions like diabetes, heart disease, and mental health disorders is having on doctor’s offices. A University of Calgary-led study, published in the Annals of Family Medicine, shows multiple compounding factors behind the current physician shortage in Alberta.

“People are older, and sicker,” says Dr. Braden Manns, MD, a professor at the Cumming School of Medicine and lead investigator. “The number of people with five or more health conditions – like a history of cancer, high blood pressure and heart issues – nearly doubled. That puts a lot of pressure on family doctors and the entire health system.”

Manns says many family doctors talk about this trend, however, this study quantifies it. The research team created annual snapshots from 2004 to 2020 of every Albertan adult seen by a family physician. The data included physician billing claims, health records and hospital and ambulance reports.

The team tracked patient mix (age, number of chronic conditions, mental health and substance-use conditions) and physician workload (number of clinic days providing primary care, patient seen in clinic each day, and the number of adult patients cared for per year).

Number of female family physicians increased

In addition to the increase in patient age and case complexity the key findings include notable changes in related to family physicians and their practice over time:

• The number of female family physicians increased from 39 per cent in 2004 to 47 per cent in 2020
• Family doctors trained in low- and middle-income countries rose to 17 per cent from 6 per cent
• The average number of patients seen per day by a family doctor fell from 23 in 2004 to 20 in 2020.

Average days worked each year by family physicians decreased from 167 in 2004 to 156 in 2020.
“These system level shifts help explain access pressures in primary care and offer a clear signal for health systems to use in workforce planning and resource allocation to meet rising patient complexity,” says Manns. “The solution isn’t just more doctors, or doctors with more time. We need to expand primary care teams that include allied health professionals in one place, under one roof.”

Canada has a growing shortage of family physicians, with nearly 8.5 million Canadians or 15% of the population without a family doctor, according to a 2024 study published in the Canadian Medical Association Journal. In Alberta, the number of family practices accepting new patients has decreased dramatically over the past few years, from nearly 900 in 2020 to 164 in 2024, Alberta Find a Doctor reports.

Primary care networks can help with increasing complexity

Manns says an example of teams are Alberta’s Primary Care Networks, where family doctors work alongside other allied health professionals like nurses, dieticians and social workers to address patient’s needs. Teams have been shown to improve care and take some of the load off physicians.

But while nearly three quarters of Albertans receive care in primary care networks, funding for teams remains very limited, with only about four allied health professionals for every 10 family physicians.

Manns adds other tactics that can be considered include making primary care a more attractive option for learners and adding more nurse practitioners working in collaboration with family physicians.

Braden Manns is a professor in the Department of Medicine and the senior associate dean (Health Research) at the Cumming School of Medicine (CSM) and associate vice president (Health Research) at the University of Calgary. He is a member of Libin Cardiovascular Institute, and the O’Brien Institute for Public Health at the CSM.

Source University of Calgary

References

Changes in Family Physicians Over Time in Alberta, Canada: A 16-Year Population-Based Cohort Study, Manns BJ, McDonald T, McBrien K, Johnston A, Green L, Au F, Tonelli M. Ann Fam Med. 2025 Sep 22;23(5):419-426. doi: 10.1370/afm.240514. PDF

Public experiences and perspectives of primary care in Canada: results from a cross-sectional survey, Kiran T, Daneshvarfard M, Wang R, Beyer A, Kay J, Breton M, Brown-Shreves D, Condon A, Green ME, Hedden L, Katz A, Keresteci M, Kovacina N, Lavergne MR, Lofters A, Martin D, Mitra G, Newbery S, Stringer K, MacLeod P, van der Linden C. CMAJ. 2024 May 20;196(19):E646-E656. doi: 10.1503/cmaj.231372. PDF

Also see
16-year study suggests improvements to Alberta’s primary care, doctor retention CTV News