Evolution of the Role of Family Physicians in the Context of Their Interprofessional Collaboration with Advanced Nurse Pratitioners

Physicians practise within complex health care environments in which governments are endeavouring to ensure citizens’ access to quality primary care services while simultaneously controlling costs. Within this context, the development and implementation of advanced practice nursing (APN) roles is one of the important initiatives of recent decades. A growing number of physicians have therefore had to determine how best to exercise their role relative to that of these health professionals. Much has been written about the development and implementation of the APN role, including some discussion within Medicine. However, little information exists about how physicians’ view their role relative to that of these health professionals. Physicians experience a number of well-documented pressures (e.g., large caseloads, increasingly complex cases) as they endeavour to provide the best possible services while also maintaining a satisfying professional life, these pressures potentially having negative consequences (e.g., burnout, moral distress). In this context, it is important to understand physicians’ perspectives regarding this evolution in the organization of practice. The purpose of this talk is to present the findings from an investigation conducted in the province of Quebec (Canada) regarding family physicians’ perspectives about their role relative to that of primary care ANPs. We conducted nine in-depth semi-directed individual interviews and two focus groups with ten physicians. Physicians reported three areas in which their practice was influenced : 1) client composition and scope of practice; 2) the type of follow-up; and 3) teamwork. The physicians' perceptions about the transformation of their role include both losses and gains; they seem to experience a certain ambivalence about a redefinition of their role, which in turn is linked with the meaning that they gain in their work.