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Psychologist and Physician Inter-Professional Collaborative Experiences in Primary Care Integration

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Abstract

In recent years, the subject of integrated healthcare, including the integration of behavioral health services into primary care, within the healthcare field has been increasingly of interest to researchers, providers, and policy makers. However, little is known about the experiences of providers within integrated care and the impact of these experiences on inter-professional relationships and collaboration. The researchers aimed to explore differences in providers’ perspectives, including inter-professional collaboration and overall job satisfaction, by provider type and level of integration. The current study uses a mixed method exploratory approach, gathering both qualitative and quantitative data to investigate the perspectives of providers (both psychologists and physicians) on their work together. This study included 30 psychologists and 30 primary care physicians from three levels of healthcare integration (traditional/coordinated, co-located, and integrated). As hypothesized, results indicated that providers in integrated settings were the most satisfied with their collaboration with other providers. Furthermore, the providers’ narratives revealed promising insights which contribute to a broader understanding of how to improve the relationships between psychologists and primary care physicians in integrated healthcare and other settings.

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References

  • Aguirre-Duarte, N. (2015). Increasing collaboration between health professionals. Clues and challenges. Colombia Medica, 46, 66–70.

    PubMed  PubMed Central  Google Scholar 

  • American Psychological Association. (2014). Briefing series on the role of psychology in health care- integrated health care. Retrieved February 11, 2017, from https://www.apa.org/health/briefs/integrated-healthcare.pdf

  • American Psychological Association. (2018). Demographics of the U.S. psychology workforce: Findings from the 2007–16 American community survey. Washington: American Psychological Association.

    Google Scholar 

  • Ashworth, C. D., Williamson, P., & Montano, D. (1984). A scale to measure physician beliefs about psychosocial aspects of patient care. Social Science & Medicine, 19, 1235–1238.

    Article  CAS  Google Scholar 

  • Ballenger-Browning, K. K., Schmitz, K. J., Rothacker, J. A., Hammer, P. S., Webb-Murphy, J. A., & Johnson, D. C. (2011). Predictors of burnout among military mental health providers. Military Medicine, 176, 253–260.

    Article  PubMed  Google Scholar 

  • Beehler, G. P., & Wray, L. O. (2012). Behavioral health providers' perspectives of delivering behavioral health services in primary care: A qualitative analysis. BMC Health Services Research, 12, 337.

    Article  PubMed  PubMed Central  Google Scholar 

  • Blount, F. A., & Miller, B. F. (2009). Addressing the workforce crisis in integrated primary care. Journal of Clinical Psychology in Medical Settings, 16, 113.

    Article  PubMed  Google Scholar 

  • Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: Care of the patient requires care of the provider. Annals of Family Medicine, 12, 573–576. https://doi.org/10.1370/afm.1713.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bray, J. H., & Rogers, J. C. (1995). Linking psychologists and family physicians for collaborative practice. Professional Psychology: Research and Practice, 26, 132–138.

    Article  Google Scholar 

  • Bruner, P., Waite, R., & Davey, M. (2011). Providers’ perspectives on collaboration. International Journal of Integrated Care, 11, 1–11.

    Article  Google Scholar 

  • Burfeind, G., Seymour, D., Sillau, S. H., Zittleman, L., & Westfall, J. M. (2014). Provider perspectives on integrating primary and behavioral health: A report from the high plains research network. Journal of the American Board of Family Medicine: JABFM, 27, 375–382. https://doi.org/10.3122/jabfm.2014.03.130152.

    Article  PubMed  Google Scholar 

  • Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., & Wilt, T. J. (2008). Integration of mental health/substance abuse and primary care. (No. 173). Rockville, MD: Agency for Healthcare Research and Quality. Retrieved February 11, 2017, from https://www.ncbi.nlm.nih.gov/books/NBK38632/

  • Chomienne, M., Grenier, J., Gaboury, I., Hogg, W., Ritchie, P., & Farmanova-Haynes, E. (2010). Family doctors and psychologists working together: Doctors' and patients' perspectives. Journal of Evaluation in Clinical Practice, 17, 282–287.

    Article  PubMed  Google Scholar 

  • Data USA. (2018). Physicians & surgeons.

  • DeStefano, T. J., Clark, H., Gavin, M., & Potter, T. (2005). The relationship between work environment factors and job satisfaction among rural behavioral health professionals. Journal of Community Psychology, 84, 1–7.

    Google Scholar 

  • Doherty, W., McDaniel, S. H., & Baird, M. (1996). Five levels of primary care/behavioral healthcare collaboration. Behavioral Healthcare Tomorrow, 5, 25.

    CAS  PubMed  Google Scholar 

  • Domenech, J., Sánchez-Zuriaga, D., Segura-Ortí, E., Espejo-Tort, B., & Lisón, J. F. (2011). Impact of biomedical and biopsychosocial training sessions on the attitudes, beliefs, and recommendations of health care providers about low back pain: A randomised clinical trial. Pain, 152(11), 2557–2563.

    Article  CAS  PubMed  Google Scholar 

  • Eklund, M., & Rahm Hallberg, I. (2000). Factors influencing job satisfaction among Swedish occupational therapists in psychiatric care. Scandinavian Journal of Caring Sciences, 14, 162–171.

    Article  CAS  PubMed  Google Scholar 

  • Epstein, R. M., Fiscella, K., Lesser, C. S., & Stange, K. C. (2010). Why the nation needs a policy push on patient-centered health care. Health Affairs, 29, 1489–1495.

    Article  PubMed  Google Scholar 

  • Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191.

    Article  PubMed  Google Scholar 

  • Funderburk, J. S., Fielder, R. L., DeMartini, K. S., & Flynn, C. A. (2012). Integrating behavioral health services into a university health center: Patient and provider satisfaction. Families, Systems, & Health, 30(2), 130–140. https://doi.org/10.1037/a0028378.

    Article  Google Scholar 

  • Gavin, L. A., Wagers, T. P., Leslie, B., Price, D. W., Thorland, W., & deGroot, C. S. (1998). Medical and mental healthcare providers' attitudes about collaboration. Families, Systems, & Health, 16, 139–146. https://doi.org/10.1037/h0089847.

    Article  Google Scholar 

  • Heath, B., Wise Romero, P., & Reynolds, K. (2014). A standard framework for levels of integrated healthcare. Washington: SAMHSA-HRSA Center for Integrated Health Solutions.

    Google Scholar 

  • Hill, C. E., Thompson, B. J., & Williams, E. N. (1997). A guide to conducting consensual qualitative research. The Counseling Psychologist, 25, 517–572.

    Article  Google Scholar 

  • Huang, S., Fong, S., Duong, T., & Quach, T. (2016). The affordable care act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans. Translational Behavioral Medicine, 6, 309–315.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kringos, D. S., Boerma, W., van der Zee, J., & Groenewegen, P. (2013). Europe's strong primary care systems are linked to better population health but also to higher health spending. Health Affairs (Project Hope), 32, 686–694. https://doi.org/10.1377/hlthaff.2012.1242.

    Article  Google Scholar 

  • Landon, B. E., Reschovsky, J., & Blumenthal, D. (2003). Changes in career satisfaction among primary care and specialist physicians, 1997–2001. JAMA, 289, 442–449.

    Article  PubMed  Google Scholar 

  • McDaniel, S. H. (1995). Collaboration between psychologists and family physicians: Implementing the biopsychosocial model. Professional Psychology: Research and Practice, 26, 117.

    Article  Google Scholar 

  • Pallant, J. (2013). SPSS Survival Manual. McGraw-Hill Education (UK).

  • Pecukonis, E., Doyle, O., & Bliss, D. L. (2008). Reducing barriers to interprofessional training: Promoting interprofessional cultural competence. Journal of Interprofessional Care, 22, 417–428.

    Article  PubMed  Google Scholar 

  • Pollard, R. Q. Jr., Betts, W. R., Carroll, J. K., Waxmonsky, J. A., Barnett, S., & deGruy, F.V. III,..., Kellar-Guenther, Y. (2014). Integrating primary care and behavioral health with four special populations: Children with special needs, people with serious mental illness, refugees, and deaf people. American Psychologist, 69, 377–387https://doi.org/10.1037/a0036220

  • Pincus, H. A. (2003). The future of behavioral health and primary care: Drowning in the mainstream or left on the bank? Psychosomatics, 44, 1.

    Article  PubMed  Google Scholar 

  • Robinson, P. J., & Strosahl, K. D. (2009). Behavioral health consultation and primary care: Lessons learned. Journal of Clinical Psychology in Medical Settings, 16, 58–71.

    Article  PubMed  Google Scholar 

  • Savage, E., Hegarty, J., Weathers, E., Mulligan, L., Bradley, C., Condon, C., . . ., Jonathan, D. (2016). Transforming chronic illness management through integrated care: A systematic review of what works best and why. International Journal of Integrated Care (IJIC), 16, 1–2https://doi.org/10.5334/ijic.2942

  • Scanlan, J. N., & Still, M. (2013). Job satisfaction, burnout and turnover intention in occupational therapists working in mental health. Australian Occupational Therapy Journal, 60, 310–318.

    PubMed  Google Scholar 

  • Ventevogel, P. (2014). Integration of mental health into primary healthcare in low-income countries: Avoiding medicalization. International Review of Psychiatry (Abingdon, England), 26, 669–679.

    Article  Google Scholar 

  • Zwarenstein, M., Rice, K., Gotlib-Conn, L., Kenaszchuk, C., & Reeves, S. (2013). Disengaged: A qualitative study of communication and collaboration between physicians and other professions on general internal medicine wards. BMC Health Services Research, 13, 494. https://doi.org/10.1186/1472-6963-13-494.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to thank all research participants for their generous contributions of time and effort. The authors would also like to thank the following lab members and research assistants who contributed to this project: Brianna Driscoll, Kylie Steinhilber, and Natasha Ramanayake.

Funding

The authors disclosed the receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Suffolk University and received a Graduate Student Research Award from the Society for Health Psychology, American Psychological Association Division 38.

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Correspondence to Jenesse E. Kaitz.

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Jenesse E. Kaitz and Sukanya Ray declare that they have no conflict of interest.

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This study was approved by the Suffolk University IRB.

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Informed consent was obtained from all individual participants included in the study.

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Kaitz, J.E., Ray, S. Psychologist and Physician Inter-Professional Collaborative Experiences in Primary Care Integration. J Clin Psychol Med Settings 28, 436–446 (2021). https://doi.org/10.1007/s10880-020-09733-5

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