Perspectives of specialists and family physicians in interprofessional teams in caring for patients with multimorbidity: a qualitative study

• Published in: CMAJ open 2020-04, Vol.8 (2), p.E251-E256
• Main Authors: Boeckxstaens, Pauline, Brown, Judith Belle, Reichert, Sonja M, Smith, Christopher N C, Stewart, Moira, Fortin, Martin
• Format: Article
• Language: English
• Subjects: Adult; Aged; Attitude of Health Personnel; Delivery of Health Care; Female; Humans; Interprofessional Relations; Male; Middle Aged; Multimorbidity; Patient Care; Patient Care Team; Physicians, Family; Qualitative Research; Referral and Consultation; Specialization; Telemedicine
• ISSN: 2291-0026; 2291-0026
• DOI: 10.9778/cmajo.20190222

Patients with multimorbidity often require services across different health care settings, yet team processes among settings are rarely implemented. We explored perceptions of specialists and family physicians collaborating in a telemedicine interprofessional consultation for patients with multimorbidity to better understand the value of bringing physicians together across the boundaries of health care settings. This was a descriptive qualitative, interview-based study. Physicians who had previously participated in the Telemedicine Interprofessional Model of Practice for Aging and Complex Treatments (Telemedicine IMPACT Plus [TIP] Program) were invited to participate and asked to describe their experience of being a member of the program. Interviews were conducted from March to May 2016. We conducted an iterative and interpretive process using both individual and team analysis to identify themes. There were 15 participants, 9 specialists and 6 family physicians. Three themes emerged in the analysis: creating new perspectives on care for patients with multimorbidity by sharing knowledge, skills and attitudes; the shift from a consultant model to an interprofessional team model (allowing a window into the community, extending discussions beyond the medical model and focusing on the patient's health in context); and opportunities for learners, including learning about interprofessional collaboration and gaining exposure to a real-world model for caring for people with multimorbidity in outpatient settings. Family physicians and specialists participating in a TIP Program believed the program improved their knowledge and skills, while also serving as an effective care delivery strategy. The findings also support that learners require more exposure to nontraditional consultant models in order to care for patients with multimorbidity effectively.