Impact of Identity on Support for New Roles in Health Care: A Language Inquiry of Doctors’ Commentary

Identity threat can be understood from a social identity perspective where people interrelate based on group memberships. Language use may indicate the presence of identity threat. We explored reactions of doctors to planned expanded roles for nurses to perform gastrointestinal endoscopy in Australia. Specialist doctors have traditionally performed endoscopic procedures, yet the level of doctor support for nurse endoscopy is relatively unknown. We present results of our valence and discourse analyses of text box responses in a national survey that explored doctors’ attitudes toward this role expansion. We found low levels of support for the role, and frequent expression of identity threat in three main areas: (1) framing nurses as incompetent, (2) use of contracted statements to evoke authority, and (3) emotive expression. Findings indicated that stakeholders should consider intergroup attitudes when facilitating changes in health professional scope of practice.