Perceived role of primary care physicians in Nova Scotia's reformed health care system. Qualitative study.
OBJECTIVE
To determine primary care physicians' perceptions of their role in a reformed health system.


METHODS
Qualitative study using in-depth interviews.


METHODS
Province of Nova Scotia.


METHODS
Purposefully selected sample of 14 practising primary care physicians.


RESULTS
Participants identified seven aspects of their role: primarily, diagnosis and treatment of patient's medical problems; then coordination, counseling, education, advocacy, disease prevention, and gatekeeping. The range of activities and degree of responsibility assumed by participants, however, varied. Factors affecting role perception fell into three categories: philosophical view of health and medicine, willingness to collaborate, and practical realities. Participants differed in their understanding of primary health care and their overall vision of the health system. Remuneration policies and concerns about sharing accountability were factors preventing an integrated, collaborative approach to care. Personal, patient, and structural realities also limited physicians' roles.


CONCLUSIONS
This sample of primary care physicians had diverse perceptions of their role. Results of this study could provide information for identifying issues that need to be addressed to facilitate changes taking place in the health care system.
Sangster
L M
LM
School of Health and Human Performance, Dalhousie University, Halifax, NS.
McGuire
D P
DP
D001291:Attitude of Health Personnel; D003256:Community Participation; D005260:Female; D020793:Gatekeeping; D018166:Health Care Reform; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D009674:Nova Scotia; D010686:Philosophy, Medical; D010819:Physician's Role; D011320:Primary Health Care / Q000458:organization & administration*