Rhetorical Strategies Implemented By The American Medical Association To Identify Roles Within The Interprofessional Healthcare Team

Abstract

PURPOSE: Healthcare reform is introducing new models of care to serve complex patient needs, including expanded roles for nursing. This has resulted in interested parties debating formal definitions of provider roles in healthcare teams. The purpose of this study is to conduct a rhetorical criticism of content produced by the American Medical Association (AMA) concerning the role of providers within the healthcare team. THEORETICAL/CONCEPTUAL FRAMEWORK: This study’s framework uses rhetorical criticism, an analysis of an organization’s “strategic use of symbols to generate meaning” (Hoffman & Ford, 2010). This analysis evaluates the rhetoric on its potential function both to influence the definition of provider roles and to critique how the organization’s potential power may be implemented. By understanding what the organization displays in its public texts, one can potentially infer the intentions of the organization. METHOD: Press releases and newsletter articles publicly available from the AMA website from 2010 to 2014 were selected based on their relevance to the discussion of healthcare team leadership. The texts were analyzed using a systematic approach to identify and describe rhetorical strategies. This is a systematic, rigorous method for deconstructing texts in order to draw conclusions about the choices a rhetor made in achieving a goal. The analysis was then further enhanced with relevant contextual and historical research, analyzing the development of health care professions as disciplines in the US, and the organization’s history itself in its development as a trade association. RESULTS: Rhetorical strategies used by the AMA include: Appealing to the values of patient safety, teamwork, and competent leaders of teams; and making logical arguments based on contradictions in lay definitions of teamwork and independence. These are used to argue for maintaining legal and financial interests for physicians within healthcare systems. Limitations include analyzing select materials publicly available without an AMA membership. CONCLUSIONS: Defining the role of members within the interprofessional team is of interest to healthcare providers and their representative organizations as new models of care attempt to increase quality, access, and value within the system. As nursing organizations attempt to expand nursing scope of practice at the state level, oppositional views of these bills should be understood to provide counterarguments and effectively engage stakeholders.