Table 2.
Ownership themes common to residents and faculty members from medicine and psychiatry
| Themes | Number (%) |
Representative quotes |
|---|---|---|
| Physician actions | ||
| Advocacy | 20 (5.6) |
‘… to be their advocate when the clinical course is smooth or rough’ |
| Communication, care coordination | 175 (49.2) |
‘maintaining communication with other care providers so that continuity will be as smooth and seamless as possible’ |
| Decision making | 56 (15.7) |
‘taking responsibility for clinical decision making’ |
| Follow through | 87 (24.4) |
‘I am the one who will follow through and make sure the work on that patient gets done as expected. Things will not fall through the cracks on my watch.’ |
| Knowledge of the patient | 51 (14.3) |
‘knowing the patient stone-cold’; ‘learning as much as one can about the patient’s condition’ |
| Leadership | 12 (3.4) |
‘taking a leadership role in the care of one’s patient, whether by being the ‘sole’ person in control, leading a team or appropriately delegating tasks to others’ |
| Physician attitudes | ||
| Above and beyond | 18 (5.1) |
‘going the extra mile’; ‘a commitment to do more the minimum’ |
| ‘Buck stops here’ | 17 (4.8) |
‘you are not tagging along behind an attending … you are ‘it’’; ‘I’m responsible for seeing that my patient gets good care and if there are lapses, it’s ultimately on me’ |
| Patient outcome | 26 (7.3) |
‘feeling invested in whether the patient gets better or not’ |
| Responsibility (feeling) | 25 (7.0) |
‘to ‘own’ our patients really means, in my view, to feel responsible for their care, to feel the gravity of our interactions, decisions, and actions on their behalf’; ‘Losing sleep if something goes wrong’ |
| Physician identity | ||
| Primary care provider | 36 (10.1) |
‘I am the first person that the nurse and case manager contact … I am also the person who represents the treatment team to the family’ |
| Physician qualities | ||
| Initiative | 38 (10.7) |
‘taking initiative to suggest initial treatments and alterations in treatments where necessary’; ‘Being proactive … rather than assuming someone else has done it’ |
| Quality of care | ||
| Best care | 13 (3.6) |
‘following the golden rule, e. g. am I delivering care that I would want to deliver to a family member or myself’ |
| Comprehensive | 30 (8.4) |
‘as a physician it means taking ultimate responsibility for every aspect of a patient’s healthcare’ |
| Longitudinal | 11 (3.1) |
‘the physician … takes the long view … and avoids seeing patient care in terms of a specific, isolated episode’ |
| Patient-centred | 29 (8.1) |
‘eliciting the patient’s perspective’; ‘trying to help empower the patient in making decisions about their medical care’ |