Table 2.

Quotations that illustrate the key elements from the findings

Nature of follow-up possible with patients
  • “You have some nurses who, on the one hand, have advocated for many years for new roles, claiming that they have the competencies to carry them out. We have family doctors who have a role and we have specialists who have a role .… My area is becoming more and more squeezed because, basically, the part that touches health promotion, follow-up, the knowledge, the global perspective, the continuity of care that I do with a patient, I’m being told, ‘Listen, when we’ll have the advanced nurse practitioners, it’s them who’ll do these things.’ What do I become as a family doctor? My strengths are the continuity, the global perspective on health, my knowledge about the individual. What will happen to the relationship, what will the doctor have, if he becomes simply a ‘walk-in clinic doctor’ who only sees individuals with serious problems?”

Sharing the scope of practice
  • “There are many, many overlaps between our roles; where does one begin and the other begin? This seems risky”

  • “Will we, the doctors, lose power, prestige, and the capacity to practise autonomously?”

  • “In my opinion … I have some concerns about the loss of power, some concerns about what will happen to the patient. Will we be making decisions with negative consequences for our patients?”

  • “Before, it was just us, the doctors; however, over time we’ve been learning how to work with other professionals, like the PHCNPs, with the physios, and so on. I have to know how to do this now, to figure out how to integrate this in my practice”

Patient profile
  • “The PHCNPs see my patients, but when they’re too sick, she sends them to me. Yes, they’re the same patients, but I see them when they’re more ill, and when they enter my office, I won’t just check their blood pressure like before …. it takes much longer. For sure it’s like that for some doctors … yes, it’s more demanding; I’m telling you”

  • “You know, the 300 patients that she follows, if she leaves tomorrow because … whatever the reason, I already have 1900 patients, OK. What do I do with the 300 patients? Not everyone seems to have understood …. this agreement with the PHCNPs; their patients are our patients. If the PHCNPs leave, we’re left with their 300 patients”

New positive work experiences
  • “It’s more agreeable, less onerous, to arrive at the office in the morning when I see that my waiting room is full; I have 20 messages from patients who want to see me and so on. It’s less onerous than being all alone in my practice all day. Having someone with whom I can talk, working in partnership. I find it very satisfying. Firstly, there’s the pleasure of working as a team rather than working all alone in my corner. It’s satisfying to know that there are 2 heads reflecting together about the patients”

  • “I have the impression that I’m more satisfied with my work and that I have a bit more time”

  • “At an intellectual level, as well …. it’s helped us to ask more questions, to be involved in teaching. When you teach, you’re obliged to check things because of the questions you’ll receive. It helps to improve our knowledge”

  • PHCNP—primary health care nurse practitioner.