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ABSTRACT
Adverse patient outcomes are often the result of conflict or poor communication among healthcare professionals. Use of interprofessional care teams can improve healthcare and delivery of services. Healthcare systems have been historically hierarchical in nature with physicians regularly taking a leadership position. The presence of hierarchy can be a source of conflict in interprofessional healthcare teams. This article analyzes qualitative data from a four-day interprofessional training for family medicine residents, pharmacy students, nurse practitioner students, and counseling psychology students. Data was collected through journals, participant observation, and focus groups. Findings from this study demonstrate three key themes related to hierarchy: (1) tension regarding the idea that the physician is the team leader or “quarterback,” (2) experiences of marginalization by team members while working in interprofessional teams, and (3) the tendency for issues regarding hierarchy to go unresolved. Additionally, authors briefly address structures within healthcare that contribute to hierarchy as well as a discussion of alternative models of teamwork and healthcare delivery.
Disclosures
This project was supported by funds from the Bureau of Health Workforce (BHW), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS). This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by the BHW, HRSA, DHHS or the U.S. Government. The authors would also like to acknowledge New Mexico State University and Memorial Medical Center for their partnership in the training program.