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- Title
Capitalizing on Synergies—A Discourse Analysis of the Process of Collaboration Among Providers of Integrative Health Care.
- Authors
Andermo, Susanne; Sundberg, Tobias; Forsberg, Christina; Falkenberg, Torkel
- Abstract
Background: 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. Methods: 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. Findings: 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. Conclusions: 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.
- Subjects
DISCOURSE analysis; INTEGRATIVE medicine; QUALITATIVE research; RANDOMIZED controlled trials; PRIMARY health care
- Publication
PLoS ONE, 2015, Vol 10, Issue 3, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0122125