Certified nurse-midwife and physician collaborative practice. Piloting a survey on the Internet.
This pilot study was designed to describe the clinical areas of collaboration, financial structures, and sources of conflict for certified nurse-midwives (CNMs) involved in nurse-midwife and physician collaborative practice (CP). A questionnaire was posted on an electronic bulletin board maintained by the Community-Based Nurse Midwifery Education Program of the Frontier School of Nursing. The nonrandom, convenience sample consisted of 78 respondents. Their mean age was 42 years; they had been in practice for a mean of 10 years, and 56% had graduate degrees. Eighty-nine percent reported involvement in CP. Eighty-three percent co-managed higher-risk women, and 46% performed vacuum-assisted deliveries or were first assistants at cesarean sections. Forty-eight percent of CNMs did not bill in their own names, and only 12% had full hospital privileges. The most common sources of conflict in CPs were clinical practice issues (100% ever encountered), power inequities (92%), financial issues (66%), and gender relations (58%). Collaborative practice is a common form of practice for CNMs and suggests a model for collaboration in other sectors of the health care system. Future research should explore methods of reducing the potential for conflict between CNMs and physicians.
Miller
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S
Institute for Health Policy Studies, UCSF, USA.
King
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T
Lurie
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P
Choitz
P
P
D000328:Adult; D003195:Computer Communication Networks; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D009721:Nurse Midwives; D019555:Physician-Nurse Relations; D011216:Practice Management, Medical; D011247:Pregnancy; D014481:United States