Role substitution of specialist medical doctors with allied-health professionals: A qualitative exploration of patients' experiences and perceptions of healthcare quality.

Abstract

The need to improve patient access, offer increased choice and improve patient outcomes whilst maintaining safe care is driving the healthcare workforce to evolve. Extending allied-health scope of practice by integrating models of care that traverse traditional professional boundaries has been one such strategy. This study explored patients' acceptance and experiences of four allied-health extended scope of practice models of care. The study aimed to identify dimensions of quality healthcare that matter to patients and describe the extent to which they perceived these to be delivered in allied-health professional role substitution models of care. Qualitative methodology using semistructured interviews were conducted with 29 participants who had received treatment from an allied-health professional role substitution model. This was a purposeful sample with recruitment across genders, agesand social backgrounds. Interviews were audio recorded, transcribedand independently analysed by two researchers using a thematic approach. Six major themes were identified which revealed dimensions of healthcare quality that were important to participants: Balancing expectations and overall satisfaction; Timely access and convenience; Continuity, integrationand coordination of care; Clinician expert skills, professional mannerand interpersonal attributes; Financial considerations when receiving care; and Perceptions of treatment outcomes. This study highlights participants' views and experiences of allied-health extended scope of practice models of care. Service delivery models were an acceptable alternative to traditional specialist medical care with the perception that extended scope of practice models of care delivered many aspects of quality care that mattered to patients.