title: Examining organizational change in primary care practices: experiences from using ethnographic methods.
abstract: BACKGROUND
  Qualitative methods are an important part of the primary care researcher's toolkit providing a nuanced view of the complexity in primary care reform and delivery. Ethnographic research is a comprehensive approach to qualitative data collection, including observation, in-depth interviews and document analysis. Few studies have been published outlining methodological issues related to ethnography in this setting.
  
  
  OBJECTIVE
  This paper examines some of the challenges of conducting an ethnographic study in primary care setting in Canada, where there recently have been major reforms to traditional methods of organizing primary care services.
  
  
  METHODS
  This paper is based on an ethnographic study set in primary care practices in Ontario, Canada, designed to investigate changes to organizational and clinical routines in practices undergoing transition to new, interdisciplinary Family Health Teams (FHTs). The study was set in six new FHTs in Ontario. This paper is a reflexive examination of some of the challenges encountered while conducting an ethnographic study in a primary care setting.
  
  
  RESULTS
  Our experiences in this study highlight some potential benefits of and difficulties in conducting an ethnographic study in family practice. Our study design gave us an opportunity to highlight the changes in routines within an organization in transition. A study with a clinical perspective requires training, support, a mixture of backgrounds and perspectives and ongoing communication.
  
  
  CONCLUSIONS
  Despite some of the difficulties, the richness of this method has allowed the exploration of a number of additional research questions that emerged during data analysis.
authors.affiliation: Southern Academic Primary Care Research Unit, Monash University, Melbourne, Australia.
authors.forename: Grant
authors.initials: G
authors.lastname: Russell
authors.forename: Jenny
authors.initials: J
authors.lastname: Advocat
authors.forename: Robert
authors.initials: R
authors.lastname: Geneau
authors.forename: Barbara
authors.initials: B
authors.lastname: Farrell
authors.forename: Patricia
authors.initials: P
authors.lastname: Thille
authors.forename: Natalie
authors.initials: N
authors.lastname: Ward
authors.forename: Samantha
authors.initials: S
authors.lastname: Evans
mesh_terms: D000884:Anthropology, Cultural / Q000379:methods*; D005194:Family Practice / Q000458:organization & administration; D018166:Health Care Reform; D009864:Ontario; D010348:Patient Care Team / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D012107:Research Design