Pharmacist's identity development within multidisciplinary primary health care teams in Ontario; qualitative results from the IMPACT (†) project

Pottie, Kevin; Haydt, Susan; Farrell, Barbara; Kennie, Natalie; Sellors, Connie; Martin, Carmel; Dolovich, Lisa

doi:10.1016/j.sapharm.2008.12.002

« Previous Next »Research in Social and Administrative Pharmacy
Volume 5, Issue 4 , Pages 319-326, December 2009

Pharmacist's identity development within multidisciplinary primary health care teams in Ontario; qualitative results from the IMPACT (†) project†

Kevin Pottie, M.D., C.C.F.P., M.ClSc., F.C.F.P.
- Department of Family Medicine, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada
- Corresponding author. Tel.: +613 241 3344 (W); fax: +613 241 1846.
Susan Haydt, M.A.
- Élisabeth Bruyère Research Institute, 43 Bruyère Street, Room 704B-B, Ottawa, ON K1N 5C8, Canada
Barbara Farrell, B.Sc. (Pharm.), Pharm.D.
- Department of Family Medicine, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada
Natalie Kennie, B.Sc. (Pharm.), Pharm.D.
- Summerville Family Health Team, 101 Queensway West, 5^th Floor, Mississauga, ON L5B 2P7, Canada
Connie Sellors, B.Sc. (Pharm)
- Department of Family Medicine, McMaster University, Hamilton, P.O. Box 198, MacTier, ON P0C 1H0, Canada
Carmel Martin, M.B.B.S., M.Sc., Ph.D., M.R.C.G.P., F.R.A.C.G.P.
- Northern Ontario School of Medicine, 238 Bruyere Street, Ottawa, ON K1N 5E3, Canada
Lisa Dolovich, B.Sc. (Pharm.), Pharm.D., M.Sc.
- Centre for Evaluation of Medicines, 105 Main Street East, Level P-1, Hamilton, ON L8N 1G6, Canada

published online 27 April 2009.

Abstract

Background

Multidisciplinary team development generates changes in roles, responsibilities, and identities of individual health care providers. The Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) project introduced pharmacists into family practice teams across Ontario, Canada, to provide medication assessments, drug information, and academic detailing and to develop office system enhancements to improve drug therapy.

Objective

To analyze pharmacists' narrative accounts during early integration to study identity development within emerging team-based care.

Method

Qualitative design using 63 pharmacist narrative reports of pharmacists' experiences over a 9-month integration period. Four independent researchers with varied professional backgrounds used immersion and crystallization to identify codes and iterative grounded theory to determine and debate process and content themes relevant to identity development.

Results

The pharmacists' narratives spoke of the daily experiences of integrating into a family practice setting: feeling valued and contributing concretely to patient care; feeling underutilized; feeling like a nuisance, or feeling as though working too slowly. Pharmacist mentors helped deal with uncertainty and complexity of care. Pharmacists perceived that complementary clinical contributions enhanced their status with physicians and motivated pharmacists to take on new responsibilities. Changes in perspective, clinic-relevant skill development, and a new sense of professionalism signaled an emerging pharmacist family practice identity.

Conclusion

Pharmacists found that the integration into team-based primary health care provided both challenges and fresh opportunities. Pharmacists' professional identities evolved in relation to valued role models, emerging practice-level opportunities, and their patient-related contributions.

Keywords: Primary health care, Pharmacy, Professional identity, Interdisciplinary teams