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Table 2 Distinguishing statements for factor 2

From: Viewpoints about collaboration between primary care and public health in Canada

No. Statement   Factor 1 Factor 2 Factor 3
36 We need to have a better consciousness-raising about what collaborations might be possible and would be beneficial, and also reflect on the collaborations that we already have. Organizational 2 5 2
41 There are turf protection issues. Public health wants to make sure that they don’t get swallowed up by primary care issues. They want to deal with issues at a population level as opposed to an individual health level. Systemic/Organizational 0 4 1
14 Everybody feels that they are at capacity and there’s no room for anything more such as working on a collaboration. Organizational −2 4 −3
4 Partners need to consistently engage in dialogue to resolve issues. For example, they are working together identifying specific patients that both are involved with. Interactional 1 3 −1
43 What fosters collaboration at the organizational level is if we can keep it small to start. Organizational −1 2 0
23 I think an important facilitator of collaboration is having a memorandum of understanding (MOU) of how we work together. For example, MOU says that each partner agrees to put X hours of service in on a weekly basis and we will have a planning day every year. Organizational −1 2 −3
8 I think that people in different branches in the Ministry/ Ministries have to really believe in collaboration and support it enough so that they write policies that say these organizations are going to work together. Systemic 4 0 −2
22 I think the fee-for-service model doesn’t work. We need to have money attached in a way that fosters collaboration. To really get doctors to pay attention beyond their practice and their individual patients, we have to pay them differently if we want them to do different work. Systemic 4 0 3
31 I think the fee-for-service physician model is a disincentive to collaboration. For example, it is a disincentive to meet with collaborators during billable office hours. Systemic 3 0 2
38 I think we need models like community health centres which are globally funded (salaried physicians who work in a team setting with a range of health professionals – nurses, nutritionists, social workers). So the more we move into this kind of model, primary care and public health collaborations might become richer. Systemic 4 −1 1
24 Public health is largely in a unionized environment and is a bigger, institutional culture. They’ve got much more prescribed practices around how they can deploy staff which is a big barrier to collaboration. Organizational −3 −2 0
25 I think differing mandates are a barrier to collaboration. Public health can’t provide individual care because they are population health-based and group-based. For example public health is working on healthy food policies and trying to work with schools. Systemic −4 −2 3
33 I think the base unit of the health care system, just as WHO and everybody else around the world suggests, should be some sort of community health centre model which provides a primary care range of services practicing in the context of community. Systemic 3 −2 0
42 The lack of communication between the various government agencies is obvious just from the large number of faxes that come through. So integration of high tech communication is in its infancy and needs to be improved. Systemic −1 −3 −1
21 I think it is easy to get people in all branches/departments of the Ministry/Ministries to recognize the importance of public health and prevention. Systemic −5 −3 −5
34 We need to have a clear mandate from the top to enable public health, primary care and the rest of the health system to work together more effectively. Systemic 5 −4 0
15 For better communication there has to be availability of electronic communication mechanisms between public health and primary care. ( e.g. email listservs to share information about free mental health sessions in the community). Organizational 0 −4 0