Advanced practice nursing: Qualitative study of implications for family physicians' perceptions of their own work.
OBJECTIVE
To explore family physicians' perspectives on how best to exercise their role relative to that of primary health care nurse practitioners (PHCNPs).


DESIGN
Qualitative case study.


SETTING
Three Quebec health care regions.


PARTICIPANTS
Sixteen physicians participated. To be eligible, family physicians were required to have worked with at least 1 PHCNP for a minimum of 6 months.


METHODS
Semistructured individual and focus group interviews.


MAIN FINDINGS
The implementation of the PHCNP role can be associated with considerable redesign of family physicians' habitual ways of functioning and with important transformations in their role within primary care teams, which can lead these professionals to reflect upon the meaning of their work. The physicians identified the following 4 elements that influenced their views: the nature of follow-up possible with patients, sharing the scope of practice, the patient profile, and new positive work experiences.


CONCLUSION
The evolution of family physicians' role in the face of the PHCNP role must be situated within a discussion about the overall organization of care provision to patients and is not as straightforward as simply defining task division. This implementation also must take into account the frequently highly demanding context in which family physicians practise. Greater understanding is needed about contextual conditions that will facilitate physicians' practice within multidisciplinary teams, including the nature of, and interaction among, micro-, meso- and macro-level elements.