The long-term presence of general practitioners (GPs) in remote areas is key to ensuring access to primary care, continuity of service and the reduction of health inequalities. In a CIRANO study published in 2025, the authors showed that the incentives and coercive measures implemented by the Government of Quebec had succeeded in attracting more GPs to regional areas. But simply attracting them is not enough. Another challenge is to retain them.

In this study, the authors analyze the effects of the main incentive-based and coercive measures on the regional retention and relocation of family physicians between 1975 and 2024. Using longitudinal data from the Canadian Institute for Health Information (CIHI), the study traces successive periods of practice among family physicians across three super-regions of Quebec: university or peripheral regions, intermediate regions, and remote or isolated regions. The descriptive analysis primarily highlights substantially lower retention in remote or isolated regions than in other regions. The econometric analysis estimates the effects of the main measures examined—differential remuneration, scholarships tied to a return-of-service obligation, and regional medical staffing plans (PREM)—on the risk of relocation and on physicians’ expected length of stay. The estimates suggest that differential remuneration and PREM have a positive and significant effect on the regional retention of physicians, particularly in remote or isolated regions. In contrast, the results regarding MSSS scholarships suggest that, once their service obligation has been fulfilled, these scholarships do not lead recipient physicians to remain longer in these regions. Overall, this study shows that the evaluation of policies aimed at improving the geographic distribution of physicians must take into account not only their effects on attracting physicians to different regions, but also their effects on retaining them in those regions over the longer term.

→ Read here the 2025 study on attracting GPs to remote areas