Nurse Practitioner Perceptions and Experiences of Interprofessional Collaboration with Physicians in Primary Health Care Settings

Abstract

Primary health care reform is currently underway in Ontario with the goals of improving health care access, quality and continuity of care while increasing patient and provider satisfaction and cost effectiveness. Interprofessional collaboration in the provision of primary health care has been widely espoused in the health care literature as a means of achieving the goals of primary health care reform. Primary health care nurse practitioners in collaboration with physicians and other allied health professionals have a fundamental role in enhancing primary health care in Ontario. The purpose of this study was to explore and describe nurse practitioners’ experiences and perceptions of interprofessional collaboration with physicians in the provision of primary health care in Ontario. A qualitative descriptive study design was used and six nurse practitioners working in a variety of primary health care settings in Ontario were purposively sampled and interviewed regarding their experiences and perceptions of interprofessional collaboration with partnering physicians. Interviews were analyzed using qualitative content analysis techniques and themes were identified. Seven themes were identified as key factors influencing collaboration within the nurse practitioner – physician dyad from the nurse practitioner’s perspective. These themes included: quality of communication, complementary vision, physician remuneration methods, establishing and maintaining relationships, investing time and energy, nurse practitioner competency and expertise and mutual trust and respect. A model of nurse practitioner – physician interprofessional collaboration is used to organize the themes identified. The findings of this study support current recommendations for joint education initiatives for health care professionals and practice initiatives aimed at improving collaboration between partnering nurse practitioners and physicians. Areas for future research include incorporating the client’s experiences and perceptions within collaborative practice as well as developing and evaluating interventions that strengthen collaboration within the health care team