Short report
Primary care provider preferences for working with a collaborative support team
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* Corresponding author: Steven K Dobscha steven.dobscha@va.gov
1 Columbia Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Portland VA Medical Center, Portland, Oregon, USA
2 Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
3 Primary Care Division, Portland VA Medical Center, Portland, Oregon, USA
4 Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
5 Division of Hospital and Specialty Medicine, Portland VA Medical Center, Portland, Oregon, USA
Implementation Science 2007, 2:16 doi:10.1186/1748-5908-2-16
Published: 30 May 2007Abstract
Background
Clinical interventions based on collaborative models require effective communication between primary care providers (PCPs) and collaborative support teams. Despite growing interest in collaborative care, we have identified no published studies describing how PCPs prefer to communicate and interact with collaborative support teams. This manuscript examines the communication and interaction preferences of PCPs participating in an ongoing randomized clinical trial of a collaborative intervention for chronic pain and depression.
Methods
The trial is being conducted in five primary care clinics of a Veterans Affairs Medical Center. Twenty-one PCPs randomized to the study intervention completed a survey regarding preferences for interacting with the collaborative support team.
Results
A majority of PCPs identified email (95%) and telephone calls (68%) as preferred modes for communicating with members of the support team. In contrast, only 29% identified in-person communications as preferred. Most PCPs preferred that the care manager and physician pain specialist assess patients (76%) and make initial treatment changes (71%) without first conferring with the PCP. One-half wanted to be designated cosigners of all support team notes in the electronic medical record, one-half wanted to receive brief and focused information rather than in-depth information about their patients, and one-half wanted their practice nurses automatically included in communications. Panel size was strongly associated (p < 0.001) with preference for brief, to-the-point discussions about patients.
Conclusion
The substantial variation in PCP communication preferences suggests the need for knowledge of these preferences when designing and implementing collaborative interventions. Additional research is needed to understand relationships between clinician and practice characteristics and interaction preferences.