Electronic Thesis and Dissertation Repository

Thesis Format



Master of Science


Health and Rehabilitation Sciences


Shannon L. Sibbald


Primary care physician engagement is essential in enhancing organizational performance, system efficacy, and provider collaboration; yet limited literature exists within health systems research. This thesis explored physician engagement throughout the development of an organization known as the London Middlesex Primary Care Alliance (LMPCA). This thesis used a qualitative case study approach guided by a constructivist paradigm. The findings revealed six themes which contributed to the development of the LMPCA and provided insight into how physicians were engaged within health systems work. Unique to this study were two facilitators for engagement: the role of a transformation lead and the use of a grassroots approach to physician engagement. This study may support other regional primary care provider alliances who want to effectively engage physicians within health systems related work. This research will contribute to enhancing the quality of health systems work, including the ongoing development of Ontario Health Teams, and support the improvement of stakeholder engagement within and across primary care settings.

Summary for Lay Audience

Physician engagement refers to a physician's motivation to actively contribute, commit, and be involved with their organization. While physician engagement is identified as a key principle in health system transformation, there is limited literature around effective approaches within health systems work. Currently, Ontario is undergoing a large health care system transformation with the introduction of Ontario Health Teams (OHTs). OHTs are a collaborative group of health care providers working together to improve patient care and coordination within a specific region. To address the need for a coordinated approach to the provincial health system transformation, a group of physicians in one region of Ontario formed the London Middlesex Primary Care Alliance (LMPCA), a grassroots alliance in primary care.

The study aimed to showcase the success and describe the critical points of the LMPCA as well as understand the strategies and approaches used for physician engagement within the London-Middlesex region. This study used multiple data collection methods including interviews with primary care physicians, health care administrators and administrative support personnel of the LMPCA and Middlesex-London Ontario Health Team. Other methods to collect data was document analysis and an environmental scan which was used to identify similar primary care alliances across Ontario.

The findings of this study demonstrate the LMPCA's success in contributing to the development of OHTs and effectively addressing approaches to physician engagement. Notable findings from the data include addressing the challenges during the COVID-19 pandemic, the role of the primary care transformation lead and utilizing a grassroots approach to physician engagement. The findings also outlined some of the drivers and barriers to physician engagement, such as strong communication methods and physician remuneration. Additionally, the findings demonstrate the importance of succession planning to ensure the sustainability of the LMPCA and that physicians do not burnout.

This research can provide an opportunity for other primary care alliances who wish to initiate, improve, or strategize physician engagement in their region. The findings of this study can be beneficial for enhancing physician engagement and leadership, while also contributing to health system transformation, such as the ongoing development of OHTs.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.