Point counterpoint: the function of contradictions on an interdisciplinary health care team

In this qualitative study we used Dialectical Theory to analyze contradictions occurring between medical doctors (MDs) and nurse practitioners (NPs) working collaboratively on a health care team. The analysis of interview data revealed contradictions in two areas: (1) NPs espouse a need for heightened autonomy in their working associations with medical doctors, whereas conversely, MDs emphasize a need for ongoing connection, and (2) MDs argue that NPs should be more proactive problem solvers and frame their working relationships as educational. However, NPs argue that MDs enact patterns of behavior that limit proactive problem solving and curtail the educational potential of those relationships, thus reinforcing predictable work routines. Both areas of contradiction constitute what dialectical theorist Leslie Baxter refers to as "oppositions." Examples of these oppositions are provided in the analysis. The study concludes with an assessment of how such contradictions might constitute developmental opportunities for NPs and MDs working in collaboration.