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Perceptions of underlying practice hierarchies: Who is managing my care?

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journal contribution
posted on 05.09.2021, 22:29 by Tara N Officer, Karen McBride-HenryKaren McBride-Henry
Abstract Background The introduction of new health professional roles, such as that of the nurse practitioner and pharmacist prescriber in primary health care can lead to changes in health service delivery. Consumers, having used these roles, often report high satisfaction. However, there is limited knowledge of how these individuals position nurse practitioner and pharmacist prescriber roles within existing practice structures. Methods Semi-structured interviews were conducted with 21 individuals receiving services from these practitioners in New Zealand primary health care. Interviews were recorded and transcribed verbatim for thematic analysis. Results Participant views reflect established practice hierarchies, placing advanced practitioners ‘below’ general practitioners. Participants are unable to articulate what it was about these practitioners that meant they operated at lower tiers and often considered practitioners to act as ‘their doctor’. They also highlight structural barriers impairing the ability of these providers to operate within their full scope of practice. Conclusions While seeing value in the services they receive, consumers are often unable to position nurse practitioner and pharmacist prescriber roles within health system contexts or to articulate how they value their practitioner’s skills. Embedded structural barriers may be more visible to consumers than their interactions with the health system suggest. This may influence peoples’ ability to receive intended or optimal health services. Consumer ‘health professional literacy’ around the functions of distinct health practitioners should be supported so that they may make informed service provision choices.

History

Preferred citation

Officer, T. N. & McBride-Henry, K. (2021). Perceptions of underlying practice hierarchies: Who is managing my care? BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06931-1

Journal title

BMC Health Services Research

Volume

21

Issue

1

Publication date

01/12/2021

Publisher

Springer Science and Business Media LLC

Publication status

Published online

Online publication date

03/09/2021

eISSN

1472-6963

Article number

911

Language

en