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Public Policy and Administration


Hilda Shepeard


North Dakota health care and political leaders are facing pressure to revise health care delivery in the state. A chronic shortage of health care providers, retention issues, an aging population, and a recent population burst, as well as an abnormally high rate of physician retirement, have made health care access problematic for residents of the rural state. The purpose of this study was to explore and understand the main inhibitors and facilitators of employing interprofessional teams as a strategy to address rural physician shortages in North Dakota. Bandura’s social cognitive theory provided the framework for this phenomenological study of issues impacting the use of interprofessional teamwork for practicing physicians. Research questions focused on what physicians feel are the main inhibitors and facilitators to implementing an interprofessional teamwork model of care. A researcher-developed instrument was used to conduct 8 semistructured interviews with primary care physicians working in rural North Dakota. Data from the interviews were coded manually, using pattern coding, and interpreted using thematic analysis. The findings included 4 key inhibitors that included work environment, workforce capacity, resources, and regulations. Three key facilitators were identified: expertise, patient care, and previous experience. The findings may provide health care leaders with ideas they can use to facilitate the use of the interprofessional teams (e.g., adding educational initiatives to medical school curricula) and identify what barriers need to be removed to ensure success. The implications for social change include ensuring access to health care for North Dakota residents and those of other states facing health care delivery issues.