Capitalizing on synergies-a discourse analysis of the process of collaboration among providers of integrative health care

Integrative health care (IHC) combines therapies and providers from complementary and conventional health care. Previous studies on IHC have shown power relations between providers but few studies have explored how the interaction develops over time. The objective of this study was to explore the de...

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Bibliographic Details
Published in:PloS one 2015-03, Vol.10 (3), p.e0122125-e0122125
Main Authors: Andermo, Susanne, Sundberg, Tobias, Forsberg, Christina, Falkenberg, Torkel
Format: Article
Language:English
Subjects:
Adult
Alternative medicine
Analysis
Clinical decision making
Collaboration
Communication
Conferences
Cooperative Behavior
Decision Making
Discourse analysis
Female
Health care
Health care industry
Health care policy
Health Personnel
Hospitals
Humans
Integrative Medicine
Interdisciplinary aspects
Interprofessional education
Male
Medicin och hälsovetenskap
Middle Aged
Neck
Neck pain
Neurobiology
Neurosciences
Nursing
Pain
Patient satisfaction
Patients
Primary care
Qualitative research
Society
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Summary:Integrative health care (IHC) combines therapies and providers from complementary and conventional health care. Previous studies on IHC have shown power relations between providers but few studies have explored how the interaction develops over time. The objective of this study was to explore the development of IHC collaboration and interaction among participating providers during a series of consensus case conferences for managing patients with back and neck pain. This qualitative study was conducted within a pragmatic randomized controlled clinical trial in primary care. Patients' treatment plans were developed based on IHC provider consensus conferences (n = 26) of which 15 (5 of the first, 5 in the middle, and 5 of the last in the clinical trial) were selected for analysis. Findings were derived by means of discourse analysis, focusing on the participants' use of subject positions during the conferences. The IHC team in this study gradually formed a group identity, moving their subject positions from individual treating subjects to members of a team and were able to make consensus-based decisions about patients' individual treatment plans. In the discourse, the IHC team identified collaborative shortcomings and problematized the provision of IHC. They were able to capitalize on the synergies in their collaboration and developed a shared vision of IHC provision. The process of IHC collaboration involved the gradual formation of an IHC team identity, which facilitated interdisciplinary, non-hierarchical consensus-based decision-making in the team. The discourse further suggests that a reform of some legal and organizational health sector barriers might be needed to realize sustainable implementation of IHC services in Sweden.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0122125