Professional Role Identity: At the Heart of Medical Collaboration Across Organisational Boundaries.

Nassera Touati,Jean-Louis Denis,Charo Rodríguez,Lara Maillet,Marie-Andrée Paquette

doi:10.5334/ijic.4184

Abstract

Purpose:The purpose of this paper was to help answer two persistent calls in the literature: the first asks to strengthen the understanding of medical collaboration across levels of healthcare delivery; the second one requests paying more attention to the individual experience of different forms of professional work. Accordingly, the study was guided by the following research question: How do family physicians and specialists working at different levels of healthcare delivery enact their professional identity when interacting in their situated clinical contexts?Methodology:This was a multiple interpretive case study in which, based on Giddens’ ideas, professional identity was viewed as a dynamic structural element of social life recursively related to professionals’ collaborative actions through sensemaking processes. The study involved 57 participants. Face-to-face individual semi-structured interviews and organizational documents were the main sources of data. Deductive-inductive thematic analysis was adopted as strategy for data analysis.Findings:Three prevailing physicians’ identity roles were elicited: medical expert, care coordinator, and team member. These professional identities, not mutually exclusive, were instantiated in three specific modalities of collaboration: quasi-inexistent, restrained, and extended. The entanglement of a particular identity role and a specific collaborative practice became meaningful through a complex net of organizational and institutional features, and patients’ nosological profiles.

Highlights

Change towards collaboration has been a pervasive trend in many institutional fields as well as in the healthcare sector
In order that current trends towards collaborative practices are successful in the healthcare field, across disciplinary as well as organizational boundaries, there is the need to construct legitimated health professional role identities: “Legitimizing a new identity is a form of institutional work important to institutional change
Our analysis revealed that this lack of collaboration was intertwined with a particular identity profile of the physicians: they are used to viewing themselves as medical experts in their specific scope of practice

Summary

RESEARCH AND THEORY

Professional Role Identity: At the Heart of Medical Collaboration Across Organisational Boundaries. Purpose: The purpose of this paper was to help answer two persistent calls in the literature: the first asks to strengthen the understanding of medical collaboration across levels of healthcare delivery; the second one requests paying more attention to the individual experience of different forms of professional work. The study was guided by the following research question: How do family physicians and specialists working at different levels of healthcare delivery enact their professional identity when interacting in their situated clinical contexts? Findings: Three prevailing physicians’ identity roles were elicited: medical expert, care coordinator, and team member. These professional identities, not mutually exclusive, were instantiated in three specific modalities of collaboration: quasi-inexistent, restrained, and extended. The entanglement of a particular identity role and a specific collaborative practice became meaningful through a complex net of organizational and institutional features, and patients’ nosological profiles

Introduction

Theory and methods

Enacting team membership via extended collaboration

Findings

Discussion and Conclusions