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Roles and responsibilities of family physicians on geriatric health care teams

Health care team members’ perspectives

Jocelyn Lockyer, PhD
Associate Professor in the Department of Community Health Sciences and Associate Dean of Continuing Medical Education and Professional Development at the University of Calgary

Herta Fidler, MSc
Research Associate in Continuing Medical Education and Professional Development at the University of Calgary

Marianna Hofmeister, MA
Research Assistant in Continuing Medical Education and Professional Development and a doctoral student at the University of Calgary

Correspondence to: Dr Bruce Wright, G301, 3330 Hospital Dr NW, Calgary, AB T2N 4N1; telephone 403 220-4262; e-mail wrightb{at}ucalgary.ca

OBJECTIVE To examine the beliefs and attitudes of FPs and health care professionals (HCPs) regarding FPs’ roles and responsibilities on interdisciplinary geriatric health care teams.

DESIGN Qualitative study using focus groups.

SETTING Calgary Health Region.

PARTICIPANTS Seventeen FPs and 22 HCPs working on geriatric health care teams.

METHOD Four 90-minute focus groups were conducted with FPs, followed by 2 additional 90-minute focus groups with HCPs. The FP focus groups discussed 4 vignettes of typical teamwork scenarios. Discussions were transcribed and the 4 researchers analyzed and coded themesand subthemes and developed the HCP focus group questions. These questions asked about HCPs’ expectations of FPs on teams, experiences with FPs on teams, and perspectives on optimal roles on teams. Several meetings were held to determine themes and subthemes.

MAIN FINDINGS Family physicians identified patient centredness, role delineation for team members, team dynamics, and team structure as critical to team success. BothFPs and HCPs had a continuum of beliefs about the role FPs should play on teams, including whether FPs should be autonomous or collaborative decision makers, the extent to which FPs should work within or outside teams, whether FPs should be leaders or simply members of teams, and the level of responsibility implied or explicit in their roles.

CONCLUSION Comments from FPs and HCPs identified intraprofessional andinterprofessional tensions that could affect team practice and impede the development of high-functioning teams. It will be important, as primary care reform continues, to help FPs and HCPs learn how to work together effectively on teams so that patients receive the best possible care.