Power dynamics and interprofessional collaboration: How do community pharmacists position general practitioners, and how do general practitioners position themselves?

Figures & data

Table 1. Participant demographics, retrieved from (Rakvaag, Søreide, Meland et al., 2020).

Variable	Category	Pharmacists (n = 12)	Physicians (n = 10)
Gender	Female Male	9 3	4 6
Age (years)	Mean Range	35 25–58	45 36–66
Work experience (years)	Mean Range	8 0.6–30	17 8–38
Level of education	Bachelor’s degree Master’s degree	0 12	NA
Current workplace	Community pharmacy Hospital pharmacy	10 2	NA
Experience as GP (years)	Mean Range	NA	11 1–37
Currently working as a GP	Yes No	NA	7 3

NA: not applicable

Table 2. Interview guide for physicians.

Theme	Questions
The GPs	What would you say characterizes a good GP? What are the typical features of physicians’ professional culture? (Could you characterize ‘the typical physician’? Are there any unwritten rules or norms that physicians follow?) As a GP, I assume that one often finds oneself in situations where there is not one single correct answer to a clinical problem. How do you feel about having to make decisions in such gray areas?
The pharmacists	What would you say characterizes a good pharmacist? Do you think GPs and pharmacists have the same priorities/consider the same things as important?
Collaboration	How would you describe your collaboration with pharmacists? Could you please tell us about the last time you had a clinical conversation with a pharmacist, and how the conversation went? How would you describe your trust in pharmacists? When you are in contact with pharmacists, do you feel that they have trust in you as a GP? How do you perceive the division of responsibility between GPs and pharmacists? (For example: who do you see as having responsibility for patient compliance, correct dosage, drug information, practical use of the drug, drug interactions, side effects, etc.?) If you set aside practical factors, such as time shortage and lack of communication platforms, which other factors influence your collaboration (or lack of collaboration) with pharmacists? How do you perceive the need to improve your collaboration with pharmacists? Who should contribute with what in order to improve collaboration?
Findings From Previous Study/Reactions to These
Shopkeepers/commercial aspect of pharmacy	In a previous study, we found that many GPs perceived community pharmacists more as shopkeepers than as health care personnel and were uncertain about the pharmacists’ competence as well as their agenda. The pharmacists did not agree with being shopkeepers. What are your thoughts on this finding? Why do you think this is the case?
Proactive pharmacists	The GPs are probably the most important collaborators for the pharmacists, outside of their own profession, and the contact with other types of health care personnel is much more infrequent. GPs probably deal a lot more with many different types of health care personnel, as well as with other collaborators. How do you perceive your collaboration with pharmacists compared to with your other collaborators? In our previous study, we found that a proactive approach by the pharmacists was important in order to achieve a successful collaboration with GPs. (A definition of what we mean by proactiveness) Do you have any reflections concerning this finding, based on your personal experiences? Can you tell us about an occasion when a pharmacist was proactive toward you? What did she/he do? In our study, we also found that knowing each other was important for collaboration. What are your thoughts regarding this finding?
Communication	In our study, we found that some pharmacists were afraid of insulting the GPs whenever they had to contact them regarding prescription errors, and that some GPs felt criticized as they were only contacted whenever there was something wrong with a prescription. What are your thoughts about this finding?

Pharmacists: community pharmacists

Table 3. Interview guide for pharmacists.

Theme	Questions
The pharmacists	What do you see as the characteristics of a good pharmacist? Do you have any thoughts about what differentiates pharmacists from other health care personnel? What are the typical features of pharmacists’ professional culture? (Could you characterize ‘the typical pharmacist’? Are there any unwritten rules or norms that pharmacists follow?) Sometimes when working as a pharmacist at the pharmacy, you find yourself in a situation where there is no single correct answer to a problem. How do you feel about having to make decisions in such gray areas?
The GPs	What do you see as the characteristics of a good GP? Do you see any similarities or differences within the professional cultures of pharmacists and of physicians? Do you think pharmacists and GPs have the same priorities/consider the same things as important?
Collaboration	Could you please tell us about the last time you had a clinical conversation with a GP, and how the conversation went? Do you trust the GPs? When you are in contact with GPs, do you feel that the GPs trust you as a pharmacist? How do you perceive the division of responsibility between pharmacists and GPs? (For example: who do you see as having responsibility for patient compliance, correct dosage, drug information, practical use of the drug, drug interactions, side effects, etc.?) How would you describe your collaboration with GPs? If you set aside practical factors, such as time shortage and lack of communication platforms, which other factors influence your collaboration (or lack of collaboration) with GPs? How do you perceive the need to improve your collaboration with GPs? Who should contribute with what in order to improve collaboration?
Findings From Previous Study/Reactions to These
Proactive pharmacists	In a previous study, we found that a proactive approach by the pharmacists was important in order to achieve a successful collaboration with GPs. (A definition of what we mean by proactiveness) Do you have any reflections concerning this finding, based on your personal experiences? To what extent do you see yourself as being proactive toward GPs? How have proactive approaches from your side been received by the GPs? In our previous study, we also found that knowing each other was important for collaboration. What are your thoughts regarding this finding?
Communication	In our study, we found that some pharmacists were afraid of insulting the GPs whenever they had to contact them regarding prescription errors. What are your thoughts about this finding? Do you express yourself in a particular way when contacting physicians?
Shopkeepers/commercial aspect of pharmacy	In our previous study, we found that many GPs perceived community pharmacists more as shopkeepers than as health care personnel and were uncertain about the pharmacists’ competence as well as their agenda. The pharmacists did not agree with being shopkeepers. What are your thoughts on this finding? Why do you think this is so/the case?

Rakvaag, H., Søreide, G. E., Meland, E., & Kjome, R. L. S. (2020). Complementing or conflicting? How pharmacists and physicians position the community pharmacist. Pharmacy Practice, 18(3), 2078-2078. https://doi.org/10.18549/PharmPract.2020.3.2078

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