"It's Tricky": Care Managers' Perspectives on Interacting with Primary Care Clinicians

Area of Science:

• Health Services Research
• Qualitative Health Research
• Interprofessional Collaboration

Background:

• Care management programs aim to improve chronic disease outcomes.
• Collaboration between care managers and primary care clinicians is crucial for program success.
• Understanding care managers' perspectives on this collaboration is vital.

Purpose of the Study:

• To explore care managers' perspectives on interacting with primary care clinicians.
• To identify facilitators and barriers to effective collaboration in chronic disease management.
• To understand how care manager roles and hierarchy impact interprofessional relationships.

Main Methods:

• Conducted semi-structured qualitative interviews with 29 care managers.
• Utilized a grounded theory approach for iterative analysis of interview transcripts.
• Included care managers from diverse healthcare settings (health plans, specialty clinics, hospitals, primary care).

Main Results:

• Care managers view primary care clinicians as central to patient care and utilization management.
• Barriers to interaction include variability in care manager roles and primary care clinician understanding.
• Electronic medical record use often replaces direct communication, and perceived hierarchy creates challenges.
• Care managers reported feeling inferior to primary care clinicians, impacting collaboration.

Conclusions:

• Despite recognizing the importance of primary care clinician interaction, collaboration is limited.
• Communication challenges, role ambiguity, and hierarchical structures impede effective teamwork.
• Addressing these barriers is essential for optimizing care management program effectiveness.