Skip to main content
Top
Published in: BMC Health Services Research 1/2007

Open Access 01-12-2007 | Research article

Motives and preferences of general practitioners for new collaboration models with medical specialists: a qualitative study

Authors: Annette J Berendsen, Wim HGM Benneker, Betty Meyboom-de Jong, Niek S Klazinga, Jan Schuling

Published in: BMC Health Services Research | Issue 1/2007

Login to get access

Abstract

Background

Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates GPs to initiate and continue participating with medical specialists in new collaborative care models.
The following two questions are addressed in this study:
What motivates GPs to initiate and sustain new models for collaborating with medical specialists?
What kind of new collaboration models do GPs suggest?

Methods

A qualitative study design was used. Starting in 2003 and finishing in 2005, we conducted semi-structured interviews with a purposive sample of 21 Dutch GPs. The sampling criteria were age, gender, type of practice, and practice site. The interviews were recorded, fully transcribed, and analysed by two researchers working independently. The resulting motivational factors and preferences were grouped into categories.

Results

'Developing personal relationships' and 'gaining mutual respect' appeared to dominate when the motivational factors were considered. Besides developing personal relationships with specialists, the GPs were also interested in familiarizing specialists with the competencies attached to the profession of family medicine. Additionally, they were eager to increase their medical knowledge to the benefit of their patients. The GPs stated a variety of preferences with respect to the design of new models of collaboration.

Conclusion

Developing personal relationships with specialists appeared to be one of the dominant motives for increased collaboration. Once the relationships have been formed, an informal network with occasional professional contact seemed sufficient.
Although GPs are interested in increasing their knowledge, once they have reached a certain level of expertise, they shift their focus to another specialty.
The preferences for new collaboration models are diverse. A possible explanation for the differences in the preferences is that professionals are more knowledge driven than organisation driven as the acquiring of new knowledge is considered more important than the route by which this is achieved. A new collaboration model seems a way to acquire knowledge. Once this is achieved the importance of a model possibly diminishes, whereas the professional relationships last.
Literature
1.
go back to reference Wynia MK, Latham SR, Kao AC, Berg JW, Emanuel LL: Medical professionalism in society. N Engl J Med. 1999, 341: 1612-1616. 10.1056/NEJM199911183412112.CrossRef Wynia MK, Latham SR, Kao AC, Berg JW, Emanuel LL: Medical professionalism in society. N Engl J Med. 1999, 341: 1612-1616. 10.1056/NEJM199911183412112.CrossRef
2.
go back to reference Hungin P, Seifert B: Poor communication between clinicians - poor care for patients!. Dig Liver Dis. 2004, 36: 309-310. 10.1016/j.dld.2004.01.017.CrossRef Hungin P, Seifert B: Poor communication between clinicians - poor care for patients!. Dig Liver Dis. 2004, 36: 309-310. 10.1016/j.dld.2004.01.017.CrossRef
3.
go back to reference Hardy B, Mur-Veemanu I, Steenbergen M, Wistow G: Inter-agency services in England and The Netherlands - A comparative study of integrated care development and delivery. Health Policy. 1999, 48: 87-105. 10.1016/S0168-8510(99)00037-8.CrossRef Hardy B, Mur-Veemanu I, Steenbergen M, Wistow G: Inter-agency services in England and The Netherlands - A comparative study of integrated care development and delivery. Health Policy. 1999, 48: 87-105. 10.1016/S0168-8510(99)00037-8.CrossRef
4.
go back to reference Kvamme OJ, Olesen F, Samuelsson M: Improving the interface between primary and secondary care: a statement from the European Working Party on Quality in Family Practice (EQuiP). Qual Health Care. 2001, 10: 33-39. 10.1136/qhc.10.1.33.CrossRef Kvamme OJ, Olesen F, Samuelsson M: Improving the interface between primary and secondary care: a statement from the European Working Party on Quality in Family Practice (EQuiP). Qual Health Care. 2001, 10: 33-39. 10.1136/qhc.10.1.33.CrossRef
5.
go back to reference Donohoe MT: Comparing generalist and specialty care - Discrepancies, deficiencies, and excesses. Arch Intern Med. 1998, 158: 1596-1608. 10.1001/archinte.158.15.1596.CrossRef Donohoe MT: Comparing generalist and specialty care - Discrepancies, deficiencies, and excesses. Arch Intern Med. 1998, 158: 1596-1608. 10.1001/archinte.158.15.1596.CrossRef
6.
go back to reference Cardin F, Franco-Novelletto B, Fassina R, Sturniolo G: How do general practitioners rate their relationship with gastroenterologists?. Dig Liver Dis. 2004, 36: 315-321. 10.1016/j.dld.2004.01.015.CrossRef Cardin F, Franco-Novelletto B, Fassina R, Sturniolo G: How do general practitioners rate their relationship with gastroenterologists?. Dig Liver Dis. 2004, 36: 315-321. 10.1016/j.dld.2004.01.015.CrossRef
7.
go back to reference Bowling A, Redfern J: The process of outpatient referral and care: the experiences and views of patients, their general practitioners, and specialists. Br J Gen Pract. 2000, 50: 116-120.PubMedPubMedCentral Bowling A, Redfern J: The process of outpatient referral and care: the experiences and views of patients, their general practitioners, and specialists. Br J Gen Pract. 2000, 50: 116-120.PubMedPubMedCentral
8.
go back to reference Kasje WN, Denig P, de Graeff PA, Haaijer-Ruskamp FM: Physicians' views on joint treatment guidelines for primary and secondary care. Int J Qual Health Care. 2004, 16: 229-236. 10.1093/intqhc/mzh038.CrossRef Kasje WN, Denig P, de Graeff PA, Haaijer-Ruskamp FM: Physicians' views on joint treatment guidelines for primary and secondary care. Int J Qual Health Care. 2004, 16: 229-236. 10.1093/intqhc/mzh038.CrossRef
9.
go back to reference Bridger S, Cairns SR: Survey of general practitioners' views of consultants' non-urgent referral of outpatients to other consultants. BMJ. 1996, 312: 821-822.CrossRef Bridger S, Cairns SR: Survey of general practitioners' views of consultants' non-urgent referral of outpatients to other consultants. BMJ. 1996, 312: 821-822.CrossRef
10.
go back to reference Horne R, Mailey E, Frost S, Lea R: Shared care: a qualitative study of GPs' and hospital doctors' views on prescribing specialist medicines. Br J Gen Pract. 2001, 51: 187-193.PubMedPubMedCentral Horne R, Mailey E, Frost S, Lea R: Shared care: a qualitative study of GPs' and hospital doctors' views on prescribing specialist medicines. Br J Gen Pract. 2001, 51: 187-193.PubMedPubMedCentral
11.
go back to reference Pollemans MC, Gorter SL, Rethans JJ, van der Linden S, Grol R: [Various opinions of family physicians and rheumatologists about the management of patients with rheumatoid arthritis]. Ned Tijdschr Geneeskd. 1996, 140: 2040-2044.PubMed Pollemans MC, Gorter SL, Rethans JJ, van der Linden S, Grol R: [Various opinions of family physicians and rheumatologists about the management of patients with rheumatoid arthritis]. Ned Tijdschr Geneeskd. 1996, 140: 2040-2044.PubMed
12.
go back to reference Tomlin Z, Humphrey C, Rogers S: General practitioners' perceptions of effective health care. BMJ. 1999, 318: 1532-1535.CrossRef Tomlin Z, Humphrey C, Rogers S: General practitioners' perceptions of effective health care. BMJ. 1999, 318: 1532-1535.CrossRef
13.
go back to reference Van Damme R, Drummond N, Beattie J, Douglas G: Integrated care for patients with asthma: views of general practitioners. Br J Gen Pract. 1994, 44: 9-13.PubMedPubMedCentral Van Damme R, Drummond N, Beattie J, Douglas G: Integrated care for patients with asthma: views of general practitioners. Br J Gen Pract. 1994, 44: 9-13.PubMedPubMedCentral
14.
15.
go back to reference O'Cathain A, Musson G, Munro J: Shifting services from secondary to primary care: stakeholders' views of the barriers. J Health Serv Res Policy. 1999, 4: 154-160.CrossRef O'Cathain A, Musson G, Munro J: Shifting services from secondary to primary care: stakeholders' views of the barriers. J Health Serv Res Policy. 1999, 4: 154-160.CrossRef
16.
go back to reference Marshall MN: How well do general practitioners and hospital consultants work together? A qualitative study of cooperation and conflict within the medical profession. Br J Gen Pract. 1998, 48: 1379-1382.PubMedPubMedCentral Marshall MN: How well do general practitioners and hospital consultants work together? A qualitative study of cooperation and conflict within the medical profession. Br J Gen Pract. 1998, 48: 1379-1382.PubMedPubMedCentral
17.
go back to reference Marshall MN: Qualitative study of educational interaction between general practitioners and specialists. BMJ. 1998, 316: 442-445.CrossRef Marshall MN: Qualitative study of educational interaction between general practitioners and specialists. BMJ. 1998, 316: 442-445.CrossRef
18.
go back to reference Marshall MN, Phillips DR: A qualitative study of the professional relationship between family physicians and hospital specialists. Prof Geogr. 1999, 51: 274-282. 10.1111/0033-0124.00164.CrossRef Marshall MN, Phillips DR: A qualitative study of the professional relationship between family physicians and hospital specialists. Prof Geogr. 1999, 51: 274-282. 10.1111/0033-0124.00164.CrossRef
19.
go back to reference Berendsen AJ, Benneker WHGM, Schuling J, Rijkers-Koorn N, Slaets JPJ, Meyboom-de Jong B: Collaboration with general practitioners: preferences of medical specialists – a qualitative study. BMC Health Serv Res. 2006, 6: 155-10.1186/1472-6963-6-155.CrossRef Berendsen AJ, Benneker WHGM, Schuling J, Rijkers-Koorn N, Slaets JPJ, Meyboom-de Jong B: Collaboration with general practitioners: preferences of medical specialists – a qualitative study. BMC Health Serv Res. 2006, 6: 155-10.1186/1472-6963-6-155.CrossRef
20.
go back to reference Pope C, van Royen P, Baker R: Qualitative methods in research on healthcare quality. Qual Saf Health Care. 2002, 11: 148-152. 10.1136/qhc.11.2.148.CrossRef Pope C, van Royen P, Baker R: Qualitative methods in research on healthcare quality. Qual Saf Health Care. 2002, 11: 148-152. 10.1136/qhc.11.2.148.CrossRef
21.
go back to reference Ritchie J, Spencer L: Qualitative data analysis in applied policy research. Analyzing Qualitative Data. Edited by: Bryman A and Burgess R. 1994, London, Routledge Ritchie J, Spencer L: Qualitative data analysis in applied policy research. Analyzing Qualitative Data. Edited by: Bryman A and Burgess R. 1994, London, Routledge
22.
go back to reference Vierhout WPM, Knottnerus JA, Vanooij A, Crebolder HFJM, Pop P, Wesselinghmegens AMK, Beusmans GHMI: Effectiveness of Joint Consultation Sessions of General-Practitioners and Orthopedic Surgeons for Locomotor-System Disorders. Lancet. 1995, 346: 990-994. 10.1016/S0140-6736(95)91686-5.CrossRef Vierhout WPM, Knottnerus JA, Vanooij A, Crebolder HFJM, Pop P, Wesselinghmegens AMK, Beusmans GHMI: Effectiveness of Joint Consultation Sessions of General-Practitioners and Orthopedic Surgeons for Locomotor-System Disorders. Lancet. 1995, 346: 990-994. 10.1016/S0140-6736(95)91686-5.CrossRef
23.
go back to reference Vlek JFM, Vierhout WPM, Knottnerus JA, Schmitz JJF, Winter J, Wesselingh-Megens AMK, Crebolder HFJM: A randomised controlled trial of joint consultations with general practitioners and cardiologists in primary care. Br J Gen Pract. 2003, 53: 108-112.PubMedPubMedCentral Vlek JFM, Vierhout WPM, Knottnerus JA, Schmitz JJF, Winter J, Wesselingh-Megens AMK, Crebolder HFJM: A randomised controlled trial of joint consultations with general practitioners and cardiologists in primary care. Br J Gen Pract. 2003, 53: 108-112.PubMedPubMedCentral
24.
go back to reference Schulpen GJ, Vierhout WP, van der Heijde DM, Landewe RB, Winkens RA, van der Linden S: Joint consultation of general practitioner and rheumatologist: does it matter?. Ann Rheum Dis. 2003, 62: 159-161. 10.1136/ard.62.2.159.CrossRef Schulpen GJ, Vierhout WP, van der Heijde DM, Landewe RB, Winkens RA, van der Linden S: Joint consultation of general practitioner and rheumatologist: does it matter?. Ann Rheum Dis. 2003, 62: 159-161. 10.1136/ard.62.2.159.CrossRef
25.
go back to reference Johnson W: Comparing apples with oranges. Arch Intern Med. 1998, 158: 1591-1592. 10.1001/archinte.158.15.1591.CrossRef Johnson W: Comparing apples with oranges. Arch Intern Med. 1998, 158: 1591-1592. 10.1001/archinte.158.15.1591.CrossRef
26.
go back to reference Berendsen AJ, Schuling J, Meyboom-de Jong B: [Hospital care at home; a review of the literature on the effects of a form of transmural care]. Ned Tijdschr Geneeskd. 2002, 146: 2302-2308.PubMed Berendsen AJ, Schuling J, Meyboom-de Jong B: [Hospital care at home; a review of the literature on the effects of a form of transmural care]. Ned Tijdschr Geneeskd. 2002, 146: 2302-2308.PubMed
Metadata
Title
Motives and preferences of general practitioners for new collaboration models with medical specialists: a qualitative study
Authors
Annette J Berendsen
Wim HGM Benneker
Betty Meyboom-de Jong
Niek S Klazinga
Jan Schuling
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2007
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-7-4

Other articles of this Issue 1/2007

BMC Health Services Research 1/2007 Go to the issue