Primary Care in N.B.: What does a strong primary care sector look like?

A strong primary health care system that is citizen-centered is one that “ensures that residents can get the health care they need at the right time and in the right place from the right provider¹”.

To achieve this, the following needs to be in place:

• Every citizen in New Brunswick has a primary care provider/team.
• The primary care provider/team is available when citizens need care, meaning citizens can:
  • Access care after-hours.
  • Get an appointment within five days, or, if it is a minor urgency, within two days.
• The primary care provider/team provides citizens with a good care experience. They spend enough time with them, use good communication, provide good coordination of care, offer enough support, and involve them in decisions about care.

In New Brunswick, access to primary care is a strategic pillar in the province’s health plan, and many efforts have been implemented to achieve this purpose. Models of team-based care, which are intended to provide better integrated care,  are being rolled out in the province. These models have been adopted by the New Brunswick Medical Society (such as Family Medicine NB clinics) and by the Regional Health Authorities (Horizon Health Network and Vitalité Health Network) through Local Family Health Teams. 

NB Health Link has also been created to provide access to primary care for New Brunswickers who do not have a primary care provider.

Every citizen has a primary care provider or team.

In 2024 in New Brunswick, 77% of citizens reported having a permanent primary care provider. This is the first year since 2017 without a significant drop.

In 2017, 93% of citizens reported having a permanent primary care provider (PCP)³. Since then, it has dropped over the years, down to 79% in 2023⁴. In 2024, the percentage of citizens who reported having a PCP is 77%, the first time in years that it has not decreased significantly.

Among those who have a PCP, 74% reported that they have a family doctor as their primary care provider and around 4% reported having a nurse practitioner. 

At the level of the seven health zones, a lower percentage of citizens reported having a permanent PCP (64%) in Zone 3 (Fredericton and River Valley Area) as compared to NB overall. 

The primary care provider or team is available when citizens need care.

There have been no changes in timely access to primary care services, with only 1 in 3 citizens getting an appointment with their primary care provider within 5 days.

According to the 2024 edition of the Primary Care Survey, only 1 in 3 citizens reported that they were able to see their permanent PCP within 5 days. This has not changed since 2022. This is even lower for citizens in Zone 5 (Restigouche Area), at 20%, and Zone 7 (Miramichi Area), at 26%.

Around 66% of citizens reported that their PCP did not offer care services outside clinic hours, a similar percentage compared to 2023. In Zone 2 (Fundy Shore and Saint John Area), this percentage is as high as 72%. 

When citizens cannot see their provider in a timely way, they seek other services. 70% of citizens reported using another place of care (one or more) in the last 12 months because their PCP was not available when they needed care. Consultations with a pharmacist and emergency department visits were the main alternative services they used. This percentage has not changed compared to 2023⁵.

Looking at administrative data, in 2023-2024, about half (52%) of emergency room visits in New Brunswick were caused by conditions considered non-urgent (also known as triage 4 and 5, according to their priority levels) and that could have been dealt with in a primary care setting such as the doctor’s office. This proportion was as high as 2 in 3 (62%) for Zone 4 (Madawaska and North-West Area)⁷.

Good care experience with their primary care provider.

There have been no changes in terms of experience with primary care services, with room for improvement.

From the results of the 2024 Primary Care Survey, only 1 in 2 citizens reported that their primary care provider spent enough time with them. As many as 1 in 4 reported that their PCP limits the number of problems they can discuss in a visit (either having been informed or having seen a note suggesting this). This is as high as 1 in 3 in Zone 2 (Fundy Shore and Saint John Area).

Only 2 out of 3 citizens reported that they had a good care experience with their PCP, similar to that in 2023⁵.

Percentage of citizens reporting a good care experience with their PCP in the last 12 months⁵

How are these results potentially influenced by supply and demand?

Demand for primary care

The province has been facing a significant population growth in the past several years, from almost 767,000 in 2017 to over 854,000 in 2024 (an 11% growth rate). This growth can be observed in all health zones, with Zone 1 (Moncton and South-East Area) reaching a growth rate of 21% during the same period (from just over 216,000 in 2017 to close to 263,000 in 2024).

Population Growth between 2017 and 2024⁹

This growth is coupled with a population that is aging and that has more complex needs. 23% of the population is aged 65 and over⁹, and 67% of the population aged 18 and over has one or more chronic health conditions⁵. Such a population requires not only more primary care providers but also more time with them.

Supply of primary care providers

The rates of family physicians and nurse practitioners in the province have been increasing over the past several years. The family physician rate in New Brunswick (141 per 100,000 people) is higher than the Canadian average (120 per 100,000 people)¹⁰, and the nurse practitioner rate is similar to the Canadian average (both 21 per 100,000 people)¹¹.

Changes in rate of family physicians (FP) and nurse practitioners (NP) per 100,000 people in New Brunswick and by zone between 2017 and 2023 ^10,11

According to data from the Regional Health Authorities, in 2024-2025, 27 family physicians closed their practice either due to retirement or other reasons, while 47 new family physicians were hired across the province¹².

Despite this increase in supply, the full-time equivalent (FTE) of family physicians, which is an estimate of their time spent practising family medicine based on how they bill for services, is lower than the Canadian average, and it has not changed over time¹³. As for nurse practitioners, 69% of them provided full time work in 2023¹⁴.

Primary care in New Brunswick still has a long way to go towards being a high performing, citizen-centered sector. Only 77% of citizens reported having a primary care provider (PCP) in 2024, with no improvement in timely access or care experience over time.

While multiple efforts are underway toward reaching this goal, more is still needed:

• The rate of family physicians per population has been increasing to meet an increasing demand. There is a need to have a thorough understanding of the supply of primary care providers in New Brunswick.
• Team-based practices are being implemented province-wide. They are a good strategy for better integrated care, but this requires more than just assembling professionals in a group setting. The way the group is managed must fit the needs of the clientele they are serving. Also, for a group to truly be called a team, everyone in it must share a common purpose.
• Many individual initiatives are happening to address access to primary care. Streamlining and integrating primary care delivery into an “All of New Brunswick” approach is needed instead of competitive strategies that lead to overlapping agreements, competition over resources, and eventually fragmented primary care services.

Any effort to improve primary care in the province should look at the needs of the population and ensure a smooth, integrated approach that is citizen-centered to achieve 100% attachment and improvement in timely access and care experience.

1. New Brunswick Department of Health. New Brunswick Primary Health Care Action Plan Better Together. May 2024
2. Health Care Excellence Canada. Enhancing Integrated Care.  Accessed on 28 may, 2025.
3. New Brunswick Health Council Primary Health Survey 2017.
4. New Brunswick Health Council 2023 edition of the Primary Care Survey. 
5. New Brunswick Health Council 2024 edition of the Primary Care Survey. 
6. Statistics Canada, Administrative data. Accessed on May 29, 2025. 
7. New Brunswick Department of Health, Canadian Management Information System Database metadata 2023-2024. 
8. Canadian Institute of Health Information (2023-2024). Your Health System In Depth. Ambulatory Care Sensitive Conditions for New Brunswick. 
9. Statistics Canada, Population estimates, July 1, by health region and peer group, 2023 boundaries,. Table: 17-10-0157-01. 
10. Canadian Institute of Health Information. Supply, Distribution and Migration of Physicians in Canada, 2023 — Historical Data. Ottawa, ON: CIHI; 2024. (Microsoft Excel file), Table 1. 
11. Canadian Institute of Health Information. Nursing in Canada, 2023- Data Tables. Ottawa, ON: CIHI; 2024.  (Microsoft Excel file), Table 15 “Emp dir care region per pop”. 
12. Regional Health Authorities Database, May 2024. 
13. Canadian Institute of Health Information. National Physicians Database Historical Payments- Data Tables, 1999-2000 to 2022-2023. Ottawa, ON: CIHI; 2024. (Microsoft Excel file), Table 1. 
14. Canadian Institute of Health Information. Health Workforce in Canada, 2023-Quick Stats (Microsoft Excel file), Provincial and territorial profile. Ottawa, ON: CIHI; Dec 2024.