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Volume 28 (2)
Volume 28, Issue 2, Spring 2008
J Contin Educ Health Prof 2008; 28(2):73
RESEARCH ARTICLE
Community group practices in Canada: Are they ready to reform their practice?
Suzanne Murray, Ivan Silver, Dilip Patel, Martin Dupuis, Sean M. Hayes, Dave Davis
A b s t r a c t
Introduction: Governments and healthcare organizations in Canada are reforming the clinical practice structures and policies to deliver primary care to the population. A key component of primary healthcare reform is the establishment of an interdisciplinary, community-based team approach to patient care. This study was undertaken to provide in-depth insight regarding primary healthcare providers’ beliefs and attitudes in regard to their current group practice, what changes they believe are occurring and those necessary to reform group practice settings, their willingness to embrace changes, and the challenges they face to realize the proposed reform.
Methods: This study employed a mixed-method research design (qualitative and quantitative data collection techniques) through day-long focus groups of primary healthcare professionals (eg, family physicians, specialists, dietitians, psychologists) from across Canada.
Results: There is considerable variation in the composition of primary care group practices across Canada. Respondents report that group practices are little more than an economic convenience to facilitate sharing of resources. Even when a practice is composed of several disciplines, there is little to no organized or systematic interaction among healthcare professionals aimed at improving patient care, lack of clarity as to identified leaders/managers of the team, and inconsistencies in the model of care provided to patients. However, there is a perception of value and benefit in working in a cohesive group practice to improve patient care.
Discussion: Findings revealed that although healthcare providers report themselves ready to make the necessary changes and willing to move to interdisciplinary team-based practices, there are substantive challenges that impede a movement to truly effective interdisciplinary team practice and functioning. These challenges include the type and allocation of funding, interprofessional healthcare provider education, changing the healthcare provision model, and barriers among healthcare professionals regarding shared and equitable team accountability for patient health outcomes.
Lessons for Practice
- Increase healthcare professionals’ confidence in their ability to assist the change to true interdisciplinary team practices.
- Educate healthcare professionals on what constitutes a wellness model of health care.
- Educate healthcare professionals on how to improve their use of technologies, and provide practice management and leadership training.
- Educate healthcare professionals about roles and responsibilities of allied healthcare professionals.
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