Table 4. Advanced medical students’ perceived barriers to effective physician-pharmacist collaboration (in descending order according to percentage agreeing) (n=143).

Barriers to Effective Physician-pharmacist Collaboration	Students (%) who agreed/strongly agreed
1.  Pharmacists being physically separated from patient care areas, which impairs communication with physicians.	100 (70.0)
2.  Lack of pharmacists’ access to the patient’s medical record and the medical history, laboratory data, and other information.	90 (63.0)
3.  The professional culture and tradition of physicians assuming total responsibility for clinical decision-making.	87 (60.8)
4.  Lack of both physician and pharmacist education and training in interprofessional collaboration and teamwork.	79 (55.2)
5.  Lack of physicians’ trust in pharmacists’ clinical abilities and their ability to provide direct patient care.	79 (55.2)
6.  Inability of pharmacists to document patient care recommendations in the medical record due to laws prohibiting this practice.	77 (53.8)
7.  Physicians’ concern that pharmacist patient care recommendations will conflict with their care plan for patients, causing patient harm or poor patient outcomes.	76 (53.1)
8.  Organizational obstacles such as lack of support from administration or absence of healthcare policy defining the pharmacist’s direct patient care role.	76 (53.1)
9.  Inadequate education and clinical training about direct patient care in the pharmacy school curriculum.	67 (46.9)
10.  Physicians’ feeling insecure or fear of being criticized by other members of the healthcare team during collaborative practice.	64 (44.8)
11.  Lack of incentives for pharmacists to change their practice, such as increased salaries or more professional prestige.	63 (44.1)
12.  Lack of pharmacists’ desire or willingness to change from medication dispensing to a direct patient care practice.	58 (40.6)
13.  Lack of pharmacists’ time to provide direct patient care because of dispensing duties.	48 (33.6)