Rural family physician perspectives on communication with urban specialists: a qualitative study

Wilson, Margo; Devasahayam, Augustine Joshua; Pollock, Nathaniel J.; Dubrowski, Adam; Renouf, Tia

doi:10.1136/bmjopen-2020-043470

Cited by 19 publications

(17 citation statements)

References 42 publications

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“…Last, there is acknowledgment of context as an important factor, with rural settings having unique features and characteristics in multiple ways compared to urban settings. 16 - 18 What this research adds is the multi-participant perspective within 1 study illuminating how values on the practitioner side may be reflected (or not) in the patient’s perspective. Also, this research shows how the different roles in the practice support and complement one another with their values, but how they may be executed differently.…”

Section: Discussionmentioning

confidence: 99%

Values and Meaning in Rural Primary Care Practices: Implications for Interventions Within Context

Holtrop

Nederveld

Lum

et al. 2022

J Prim Care Community Health

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Objectives: It is important to understand the unique perspectives and values that motivate patients and clinicians in rural primary care settings to participate in clinical care activities. Our objective was to explore perspectives, preferences, and values related to primary care that could influence implementation of evidence-based programs. Methods: Qualitative study utilizing semi-structured interviews and using immersion/crystallization and thematic analysis. Participants were primary care practice members (clinicians, clinical staff, and administrators) and their patients in rural Colorado. Results: Twenty-six practice members and 23 patients across 9 practices participated. There were 4 emergent themes that were consistent across practice members and some patients. Patient perspectives are located in parenthesis. They included: (1) Focus on quality patient care, patient satisfaction, and continuity of care (patients appreciated quality and compassionate care), (2) Importance of prevention and wellness (patients appreciated help with preventing health problems), (3) Clinician willingness and ability to meet patient preferences for care (patients described comfort with local care), and (4) Passion for serving underserved, uninsured, or vulnerable populations (patients described their vulnerabilities). There were differences in how the perspectives were operationalized by practice member role, illustrating the importance of different ways of addressing these values. Conclusions: Successful implementation requires consideration of context, and much of context is understanding what is important to those involved in the primary care experience. This study sheds light on salient values of rural primary care practice members and their patients, which may inform interventions designed with and for this setting.

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Section: Discussionmentioning

confidence: 99%

Values and Meaning in Rural Primary Care Practices: Implications for Interventions Within Context

Holtrop

Nederveld

Lum

et al. 2022

J Prim Care Community Health

View full text Add to dashboard Cite

show abstract

“…These specialists are the ones who receive a rural physician’s referred patients, provide advice by phone during emergencies and extend emotional support to rural physicians in low-resourced centres in times of great stress. Therefore, when an urban specialist has a pleasant demeanour, understands the conditions under which rural physicians work, and respects a rural physician’s clinical and social knowledge about their patients, it facilitates open communication, boosts confidence, and augments a sense of advocacy in rural physicians towards their community and patients [ 15 ].…”

Section: Textmentioning

confidence: 99%

To stay or not to stay: the role of sense of belonging in the retention of physicians in rural areas

Mandal

Phillips

2022

International Journal of Circumpolar Health

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Rural communities across the circumpolar region and worldwide perennially suffer from physician shortages despite decades of attempting targeted strategies for recruitment. Particularly in rural Canada, financial incentives have attracted but not retained a medical workforce. Although the importance of social connection or belonging is a long-established source of well-being, such information has not infiltrated the dialogue or action on physician retention in rural areas. A physician’s sense of belonging, arising from that emotional need for social connectedness, is built via bilateral active efforts at community engagement, reciprocity, social integration of family and workplace collegiality. Links between rural upbringing, rural training opportunities and subsequent rural practice likely rest upon fostering this sense of belonging. Policymakers and recruiters might consider how to help physicians adapt, “fit in”, and consider they have “come home” when they venture off to rural settings. Empowering the community to be involved in the recruitment and retention of rural physicians may also be effective. Perhaps this approach would better address the age-old battle to retain physicians in rural Canada and around the world.

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“…Although SCT has not been used as part of healthcare personnel's elderly communication training, it has been used as a lens to conceptualize how health personnel communicates with each other. In a study that examined communication between urban and rural physicians during consultations [5], it was found that both groups of physicians perceived that they experienced challenges in understanding each other's contexts (e.g., depth of familiarity with a patient). The language and jargon used (i.e., speech codes) were the main reasons for suboptimal communication patterns that often led to suboptimal patient outcomes.…”

Section: Proposed Solutionmentioning

confidence: 99%

Bridging the Gap in Health Personnel and Elderly Communication Training: What Can We Learn From Speech Codes Theory

Momand¹,

Barth²,

Sun³

et al. 2022

Cureus

Self Cite

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Effective communication in healthcare settings allows for the expression of complex or technical terms in a manner that each patient can understand. Communication is also linked to increased trust, patient and family satisfaction, and mutual agreement between patients and healthcare personnel. As a result of aging, the elderly (age 65 and older) may develop physical, cognitive, and social changes that may lead to barriers when interacting with healthcare personnel. As a result of these age-related changes, the elderly ability to receive, retain, and convey information may be affected. Therefore, it is essential that healthcare personnel use appropriate language when communicating with this population. Studies have suggested that simulation can be an effective means to train healthcare personnel to develop context-appropriate communication skills for this specific population. This editorial will explore how the Speech Codes Theory (SCT) can structure simulation encounters to enhance healthcare personnel's proficiency in conversing and connecting with this patient population.

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Rural family physician perspectives on communication with urban specialists: a qualitative study

Cited by 19 publications

References 42 publications

Values and Meaning in Rural Primary Care Practices: Implications for Interventions Within Context

Values and Meaning in Rural Primary Care Practices: Implications for Interventions Within Context

To stay or not to stay: the role of sense of belonging in the retention of physicians in rural areas

Bridging the Gap in Health Personnel and Elderly Communication Training: What Can We Learn From Speech Codes Theory

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