Family physician access to and wait times for cancer diagnostic investigations

Objective To examine provincial and regional differences in FPs’ direct access to cancer diagnostic investigations and advice from other specialists regarding investigations and referrals, and to explore FPs’ perceptions about wait times for diagnostic investigations and receipt of results.Design A cross-sectional, online survey.Setting British Columbia, Manitoba, and Ontario.Participants A sample of FPs from participating provinces.Main outcome measures Direct FP access to various diagnostic investigations and advice from other specialists regarding investigations and referrals; FPs’ perceptions about wait times for diagnostic investigations ordered directly; and FPs’ perceptions about wait times for results.Results A total of 1054 surveys were completed by FPs from British Columbia (n = 229), Manitoba (n = 228), and Ontario (n = 597). Distance from a cancer centre was not significantly associated with direct access to or wait times for diagnostic investigations for most of the investigations studied; however, provincial differences were observed. Family physicians in Manitoba and British Columbia were 30% to 45% less likely to report having direct access to endoscopy and some imaging investigations compared with FPs in Ontario. Family physicians in Manitoba and British Columbia were also at increased odds of waiting longer than 12 weeks for endoscopy investigations and longer than 4 weeks for imaging investigations compared with FPs in Ontario. Most FPs reported wait times of less than 2 weeks for imaging results; however, the proportion of FPs who waited longer than 2 weeks for colonoscopy results ranged from 15% in Ontario to 96% in British Columbia.Conclusion Given the disparities observed among provinces, there is an opportunity for provinces to learn from one another to improve direct access to and shorten wait times for diagnostic investigations. This in turn has the potential to shorten the primary care interval for cancer diagnostic assessment.