What is it about?

This article describes how a remote and rural health authority in Northern British Columbia engaged with primary care physicians in order to reform primary care services. A qualitative interpretive approach based on philosophical hermeneutics was used to gain insights into the complexity and subtleties of engaging physicians in system change. Data was analysed from 34 interviews with physicians, health authority leaders and primary care co-ordinators. The role of the co-ordinators was to facilitate conversations between health authority, community and physicians. Three themes are emerged from the analysis: working through tensions constructively, drawing on structures for engagement, and facilitating relationships. All three themes indicate areas to attend to in engaging physicians in attempts to reform primary care health services.

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Why is it important?

This article explains how a rural and remote health authority partnered with physicians to reform primary care health care using team based approaches.


This research highlights the importance of relationships, true partnering and flexibility related to differing rural contexts in facilitating primary care reform in rural areas.

David Snadden
University of British Columbia

Read the Original

This page is a summary of: Engaging primary care physicians in system change – an interpretive qualitative study in a remote and rural health region in Northern British Columbia, Canada, BMJ Open, May 2019, BMJ,
DOI: 10.1136/bmjopen-2018-028395.
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