MRIStudy Medical Readership Information 2020

Results of a study of the reading patterns and preferences of Canadian family conducted by the College of Family Physicians of Canada

THE COLLEGE OF LE COLLÈGE DES FAMILY PHYSICIANS MÉDECINS DE FAMILLE OF CANADA DU CANADA The College of Family Physicians of Canada 2020 About the MRI Study

The study was conducted during June-July, 2020.

A draw for an Apple iPad was ofered as an incentive for completing the survey.

The population studied was the approximately 38,000 physicians who are currently members in good standing of the College of Family Physicians of Canada. A total of 5,000 random members were invited to participate.

The e-mail message to members made it clear that the survey originated with the College of Family Physicians of Canada.

The invitation was sent in English and French.

The invitation e-mail directed physicians to the survey questionnaire in the language of their choice, located on an independent, third-party survey site.

Results were compiled using Survey Gizmo.

A total of 309 family physicians completed the survey, including 279 in English and 30 in French.

All responses were entirely anonymous.

Medical Readership Information Study 2020 1 Notes

Member survey This is a survey of members of the College of Family Physicians of Canada (CFPC), almost all of whom receive Canadian Family (CFP) as a benefit of membership. This may mean that there is some degree of “halo effect” in which overall attitudes revealed in questions regarding journal readership tend to favour CFP.

Journal readership patterns among francophone readers may be particularly affected. There are approximately 3,582 francophone active College members in Quebec (out of 4,713 active Quebec members in total). This group, by choosing membership in a national organization, rather than the provincial alternative, has shown a strong commitment to the College that may be reflected in reported readership of CFP.

Online survey This was an online survey. Five thousand random members of the CFPC received an e-mail inviting them to click on a link to the survey site. This may mean that the survey has a built-in bias toward those physicians who use e-mail and are comfortable using the Internet.

2 Medical Readership Information Study 2020 Journal readership patterns among Canadian family physicians

Focus groups and previous surveys have shown us that readership of medical publications only rarely falls into yes-no categories. In fact, we consistently fnd that there are actually four main readership patterns. Most physicians, when asked face-to-face about a given publication, will invariably describe their reading habits in terms of one of these four patterns.

The MRI study refects the following basic reading patterns: Always read The physician enjoys, trusts and relies on the journal. Reading it is also seen as a professional duty, particularly if the journal in question is published by a professional association or organization of which the physician is a member. He or she makes it a point to always pick up this publication and makes time to look through the table of contents to see what is there and what is new. This almost always includes reading one or two favourite sections and one or more major articles. Often read The physician likes the publication and will scan the cover and fip through the contents to see if there is anything of particular interest. He or she will often fnd one or more articles to read and, if so, will make time to read them. However, reading this journal is not seen as a professional duty. Sometimes read The physician is familiar with the publication, but generally does not pick it up or take it home, mainly due to lack of time. It is not a priority; however, if he or she has available time and the publication is at hand, he or she will pick it up, leaf through it, and read all or parts of one or more articles. Never read The physician either does not receive the publication or does not much like or trust it; he or she generally “puts it straight into the recycling” to quote the most common description.

Medical Readership Information Study 2020 3 Time Spent Reading

Question In an average month, how many hours do you spend reading medical publications?

Time Spent Reading Total Percentage 0-1 hours 1.4 1-2 hours 36.8 3-4 hours 25.8 5-9 hours 17.9 10+ hours 18.2 Average time spent reading 5.6 hours Range 0 to 60 hours

36.8% 25.8% 18.2% 17.9% 1.4%

AVERAGE TIME SPENT READING 5.6 HOURS RANGE 0 TO 60 HOURS TO RANGE 0

1˜2 3˜4 10+ 5˜9 0-1

HOURS SPENT READING

4 Medical Readership Information Study 2020 Number of journals read

Question On average, how many medical journals do you pick up, scan for content and read signifcant parts of in any given month?

Journals Total 1-2 41.5% 3-5 49.9% 6+ 8.7%

AVERAGE JOURNALS READ

NUMBER OF JOURNALS READ 3.3 1-2 3-5 6+

41.5 49.9 8.7

PERCENTAGE OF PHYSICIANS ˜%°

Medical Readership Information Study 2020 5 Most important Medical Publications

Question Please list the medical journals you consider essential to your practice of medicine. (List as many as you feel are important.)

TIMES TIMES English Responses # % French Responses # % CFP 195 77.1 Le Médecin du Québec 22 81.5 CMAJ 163 64.4 CFP 15 55.6 American Family Physician 74 29.2 CMAJ 11 40.7

NEJM 58 22.9 NEJM 8 29.6 Medical Post 47 18.6 BMJ 7 25.9 BMJ 43 17.0 Santé Inc. 7 25.9 JAMA 40 15.8 Profession Santé Inc 7 25.9 Diagnosis 31 12.3 Canadian Journal of Diagnosis 7 25.9 Canadian Journal of Diagnosis 29 11.5 JAMA 6 22.2 Ontario Medical Review 28 11.1 Le Clinicien 5 18.5 Lancet 26 10.3 American Family Physician 4 14.8 Canadian Journal of Rural Medicine 24 9.5 Lancet 4 14.8 Medical Letter 22 8.7 Diagnosis 4 14.8 Annals of Family Medicine 20 7.9 Canadian Journal of 3 11.1 Canadian Journal of Emergency Medicine 20 7.9 Annals of Emergency Medicine 2 7.4 Annals of Emergency Medicine 16 6.3 Medical Post 2 7.4 Journals of Obstetrics and 16 6.3 Medical Letter 1 3.7 Journal Watch 14 5.5 Journal of Obstetrics and Gynaecology 1 3.7 Paediatrics and Child Health 11 4.3 Journal of Pain & Symptom Management 8 3.2 Le Médecin du Québec 7 2.8 Annals of Internal Medicine 6 2.4 Medical Teacher 6 2.4 Santé Inc. 2 0.40

6 Medical Readership Information Study 2020 English language readership %

Question In terms of usefulness or importance to your practice of medicine, how would you rate the following types of medical information sources available in Canada? Always look through it, usually read several articles; Often look at contents, often read one or more articles; Sometimes pick it up, occasionally read an article; Generally don’t read it or don’t receive it.

100 15.2 100 19.9 100 15.0

39.0 11.3 80 80 45.5 80 6.6 67.2 60 60 60

40.4 40 40 40 23.5

20 20 20 11.2 5.4 0 0 0 CANADIAN FAMILY PHYSICIAN CANADIAN MEDICAL ASSOCIATION NEW ENGLAND JOURNAL (CFP) JOURNAL (CMAJ) OF MEDICINE PEER-REVIEWED

100 22.9 100 27.3

80 80 12.7 16.4

60 7.6 60 56.7 11.6

40 40 44.7

20 20

0 0 CANADIAN JOURNAL THE MEDICAL POST OF DIAGNOSIS NON PEER-REVIEWED NEWS ORIENTED

Medical Readership Information Study 2020 7 Sources of Continuing Professional Development

Question To what extent do you use each of the following sources of information and continuing professional development to stay current? Regularly use - this is my major source of information and CPD, Often use - this is a signifcant source of information and CPD, Sometimes use, but not a major source, Rarely or never use

100 90 80 70 60 50 40 30 20 10 0 10 20 30 40 50 60 70 80 90 100

Do not use Use

Accredited conferences 6.9 29.1 40.5 23.5

Evidence-based resources 4.2 27. 2 43.9 24.7 (eg, clinical practice guidelines, data repositories)

Self-directed courses 11.1 27.8 35.4 25.7 (eg, Self-Learning, practice based small group learning)

Peer-reviewed journals 7.9 16.1 41.1 34.9

Rounds, journal clubs, small group activities 31.5 15.2 24.2 29.1

Online education courses 19.2 11.8 33.1 35.9

Non-peer-reviewed publications 46.6 1.8 8.1 43.5

Self-assessment programs (eg, Multiple choice questions (MCQ), practice 56.3 3.5 13.4 26.8 portfolios, CME logs, multi-source feedback)

Performance practice audits 57.5 1.8 8.4 32.3

Simulators 73.2 2.5 5.6 18.7

Rarely or never use Regularly use Often use Sometimes use

8 Medical Readership Information Study 2020 Professional Websites Visited

Question How often do you visit the following types of websites for professional purposes?

100 90 80 70 60 50 40 30 20 10 0 10 20 30 40 50 60 70 80 90 100 Do not use Use Search Engines 7.9 42.8 22.9 10.6 15.8 (eg, Google, Yahoo, Bing)

Medical portals 12.3 23.5 25.6 17.1 21.5 (eg, Medscape, Web MD)

Disease information websites 9.0 23.4 31 13.8 22.8

Medical Publication websites 10.3 13.7 30.9 24.7 20.3

Pharmaceutical brand or 2.8 6.3 4.2 company websites 52.6 34.1

Social Media 70.1 8 3.1 1.7 17 (eg, Facebook, Twitter, LinkedIn)

Rarely or never use Daily Weekly Monthly Less often

Medical Readership Information Study 2020 9 Medical Websites Visited

Question Which medical websites do you visit most often? List as many as you like.

Site EN % FR % Name of Organization www.uptodate.com 167 63.5 19 67.9 Up To Date www.google.com 137 52.1 13 46.4 Google www.cfp.ca/cfpc.ca 107 40.7 11 39.3 College of Family Physicians of Canada

www.cma.cacmaj.ca 86 32.7 5 17.9 Canadian Medical Association www.aafp.org/afp 69 26.2 3 10.7 American Academy of Family Physicians www.cdc.gov 67 25.5 5 17.9 Centers for Disease Control www.phac-aspc.gc.ca 64 24.3 10 35.7 Health Canada www.mayoclinic.com 61 23.2 3 10.7 Mayo Clinic www.Rxfles.ca 59 22.4 2 7.1 RX Files www.medscape.com 55 20.9 7 25.0 MedScape www.wikipedia.org 44 16.7 7 25.0 Wikipedia www.webmd.com 43 16.3 4 14.3 Web MD www.pubmedcentral.nih.gov 41 15.6 7 25.0 PubMed/PubMed Central www.lexi.com 41 15.6 2 7.1 Lexi-comp www.emedicine.com 36 13.7 0 0 e Medicine www.nejm.org 34 12.9 6 21.4 New England Journal of Medicine www.fpnotebook.com 32 12.2 3 10.7 Family Practice Notebook www.sogc.com 32 12.2 0 0 Society of Obstetricians and Gynaecologists www.epocrates.com 32 12.2 10 35.7 Epocrates www.cochrane.org 31 11.8 3 10.7 Cochrane Library www.bmj.com 30 11.4 3 10.7 British Medical Journal www.medconsult.com 29 11.0 2 7.1 MD Consult www.topalbertadoctors.org 28 10.6 1 3.6 Towards Optimized Practice dynamed.ebscohost.com 27 10.3 4 14.3 Dynamed www.mdbriefcase.com 19 7.2 7 25.0 mdBriefCase e-CPS 19 7.2 1 3.6 Canadian Pharmacists Association www.jama.ama-assn.org 16 6.1 5 17.9 JAMA, American Medical Association www.univadis.com 12 4.6 1 3.6 Univadis www.pepidonline.com 4 1.5 0 0 PEPID online

10 Medical Readership Information Study 2020 Website Usage Patterns

Question Which of the following best describes how often you access medical information on the Internet?

Hours/month Total WEBSITE USAGE PATTERN Less than 1 hour 1.7% 71.0% 1-2 17.4% 3-4 13.5% 5-9 21.6% 10-19 21.0% 20+ 24.0% 22.2% Average time spent reading 2.0% 4.8% 12.8 hours Less often Once or more Once or more Practically or never per month per week Everyday

Question How often do you access medical information on a smartphone or tablet?

Rarely or NEVER 20.1% 1-2 per week 17.7% 1-2 per month 5.4%

56.8% of doctors access medical information Everyday

Medical Readership Information Study 2020 11 CFP in various media

Question Which versions of CFP do you read or access all or parts of (check more than one if applicable)?

The print edition The website (cfp.ca) The digital edition (page by page electronic version)

100

80 83.2

60

40 PERCENTAGE ACCESS (%) 20 25.9

9.4 7.0 0 Print Web Desktop Web Mobile Digital

PREFERRED CHOICE OF READING

12 Medical Readership Information Study 2020 Clinical Practice Guidelines

Question Family physicians routinely use Clinical Practice Guidelines in their practice. Where do you go to find the most useful and reliable guidelines?

0 10 20 30 40 50 60 70 80 90 100

Canadian Family Physician 58.0%

Canadian Task Force on Preventive Health Care 57.2%

Disease or Condition-Specifc Websites 28.3%

US Preventive Health Services Task Force 16.6%

CMA CPG Infobase 16.3%

I don’t use them 10.2%

National Guidelines Clearinghouse 3.5%

Medical Readership Information Study 2020 13 Demographics

Question Question Are you male or female? Are you currently a student, resident, member not yet CCFP, or CCFP?

Resident .5% Resident .5% Memer Memer 1.% not yet CCPnot yet CCP 1.% CCP CCP 84.% 84.%

4.6% 4.6%Male Male5.4%5.4% emale emale

Question Question Do you currently serve, or have you In what province do you in the past served as an elected or currently practise? volunteer leader of the CFPC, one of its Province % Count Chapters, or a committee or section? Alberta 12.1 34 British Columbia 18.9 53 Manitoba 5.4 15

New Brunswick 1.8 5 Newfoundland and Labrador 2.1 6 Nova Scotia 1.8 5 Yes No Ontario 42.9 120 Prince Edward Island 0.4 1 14.4% 85.6% Quebec 12.1 34 Saskatchewan 2.5 7

14 Medical Readership Information Study 2020