Accepted Type
Oral
Code
OA2-2-2
Acceptance Declaration
Accept
Additional Information
I declare I have no actual or potential conflict of interest in relation to this program.
Was this work accepted for CCME 2020?
yes
Category
General Call (Workshop, Oral Presentation, Poster Presentation)
Type
Oral
Sub Type
Education Research
Will the presenter be a:
Other
Presenter Other
faculty
Affiliation
Considered for Poster
no
Title
Are we really collaborating? Examining the primary-specialty care interface through a critical social theoretical lens
Length of Presentation
Background/Purpose
Professional organizations emphasize the importance of the primary-specialty care interface (PSI) especially for patients with chronic diseases. Despite the abundance of research to improve communication within the PSI, persistent tensions negatively impact medical education and patient care. There has been a dearth of theoretically-informed research exploring how structural, organizational and system-level factors influence the PSI.
Methods
Using diabetes as a case, we conducted a Foucauldian discourse analysis of policy, professional and educational documents, and interview transcripts with a purposive sample of primary care and specialist physicians. By analyzing the PSI as a discursive construction we sought to explore what is actually happening in efforts to improve the PSI (including the unintentional effects) and the potential consequences for education and patient care.
Results
The PSI is constructed in a way that privileges a disease-centric approach to care. Specialists occupy a position to correct the practices of problematic primary care physicians, whose expertise in managing uncertainty, complexity and relational care is relatively obscured. However, physicians described teaching and implementing initiatives intended to improve the PSI that may be unintentionally preventing socially marginalized patients from ever receiving care.
Conclusion
While efforts to improve the PSI are adopted and taught with the best intentions, our analysis suggests they may prevent development of the relationships between primary care and specialist physicians necessary for the delivery of quality patient care. Making explicit the implicit assumptions about the PSI opens space for educators to see and develop new ways of thinking about and teaching collaboration as a competency.
Keyword 1
qualitative research
Keyword 2
collaborator
Keyword 3
power
Level of Training
CPD (faculty development, CME)
Abstract Themes
Continuing Medical Education
Additional Theme (First choice)
Continuing Medical Education
Additional Theme (Second Choice)
Postgraduate
Additional Theme (Third Choice)
Faculty Development
Authors
Presenter
Rene Wong
Term 1
Yes
Term 2
Yes
Term 3
Yes
Term 4
Yes
Term 5
Yes
