Skip to main content
Top
Published in: BMC Primary Care 1/2013

Open Access 01-12-2013 | Research article

When the group practice breaks up: a qualitative study

Authors: François Marechal, Dorothée Schmidt, Evelyne Lasserre, Laurent Letrilliart

Published in: BMC Primary Care | Issue 1/2013

Login to get access

Abstract

Background

Group practices are increasingly common for primary care physicians worldwide. Although breakups are likely to happen frequently within group practices, their process has not been studied to date. The aims of this study were therefore to explore the reasons for breakups of group practices of general practitioners and to describe the associated feelings.

Methods

We conducted a qualitative study consisting of in-depth interviews of 21 general practitioners and one secretary from past group practices in the Rhône-Alpes region, France, who experienced a breakup.

Results

When getting started in group practice for the first time, young doctors did not feel ready and supported, and did not necessarily share the same expectations as their partners. The reasons for the breakups involved imbalances within the groups, contrasting working and management styles, and breakdowns in communication. The breakup process often generated long-persistent feelings of suffering and failure for almost every partner who experienced a breakup, particularly for the partner who was leaving.

Conclusions

Weakening factors exist from the very beginning of a partnership, and problems are likely to increase at every change or event occurring in the group. We provide several recommendations, including fair management, a shared project based on a precise contract, the consultation of third parties as necessary and, in the worst case scenario, leaving the group practice in time.
Literature
1.
go back to reference Paris V, Devaux M, Wei L: Health systems institutional characteristics: A survey of 29 OECD countries. 2010, OECD Health Working Papers, n°50. OECD PublishingCrossRef Paris V, Devaux M, Wei L: Health systems institutional characteristics: A survey of 29 OECD countries. 2010, OECD Health Working Papers, n°50. OECD PublishingCrossRef
2.
go back to reference Bourgueil Y, Marek A, Mousquès J: Medical group practice in primary care in six European countries, and the Canadian provinces of Ontario and Quebec: what are the lessons for France?. QES. 2007, 127: 1-8. Bourgueil Y, Marek A, Mousquès J: Medical group practice in primary care in six European countries, and the Canadian provinces of Ontario and Quebec: what are the lessons for France?. QES. 2007, 127: 1-8.
3.
go back to reference Baudier F, Bourgueil Y, Evrard I, Gautier A, Le Fur P, Mousquès J: Group practice dynamics among private general practitioners from 1998 to 2009. QES. 2010, 157: 1-6. Baudier F, Bourgueil Y, Evrard I, Gautier A, Le Fur P, Mousquès J: Group practice dynamics among private general practitioners from 1998 to 2009. QES. 2010, 157: 1-6.
5.
go back to reference Feron J-M, Cerexhe F, Pestiaux D, Roland M, Montrieux C, Paulus D: GPs working in solo practice: obstacles and motivations for working in a group? A qualitative study. Fam Pract. 2003, 20: 167-172. 10.1093/fampra/20.2.167.CrossRefPubMed Feron J-M, Cerexhe F, Pestiaux D, Roland M, Montrieux C, Paulus D: GPs working in solo practice: obstacles and motivations for working in a group? A qualitative study. Fam Pract. 2003, 20: 167-172. 10.1093/fampra/20.2.167.CrossRefPubMed
6.
go back to reference Campbell JL, Ramsay J, Green J: Practice size: impact on consultation length, workload, and patient assessment of care. Br J Gen Pract. 2001, 51: 644-650.PubMedPubMedCentral Campbell JL, Ramsay J, Green J: Practice size: impact on consultation length, workload, and patient assessment of care. Br J Gen Pract. 2001, 51: 644-650.PubMedPubMedCentral
7.
go back to reference Campbell SM, Hann M, Hacker J, Burns C, Oliver D, Thapar A: Identifying predictors of high quality care in English general practice: observational study. BMJ. 2001, 323: 784-787. 10.1136/bmj.323.7316.784.CrossRefPubMedPubMedCentral Campbell SM, Hann M, Hacker J, Burns C, Oliver D, Thapar A: Identifying predictors of high quality care in English general practice: observational study. BMJ. 2001, 323: 784-787. 10.1136/bmj.323.7316.784.CrossRefPubMedPubMedCentral
8.
go back to reference Huby G, Gerry M, McKinstry B, Porter M, Shaw J, Wrate R: Morale among general practitioners: qualitative study exploring relations between partnership arrangements, personal style, and workload. BMJ. 2002, 325: 140-142. 10.1136/bmj.325.7356.140.CrossRefPubMedPubMedCentral Huby G, Gerry M, McKinstry B, Porter M, Shaw J, Wrate R: Morale among general practitioners: qualitative study exploring relations between partnership arrangements, personal style, and workload. BMJ. 2002, 325: 140-142. 10.1136/bmj.325.7356.140.CrossRefPubMedPubMedCentral
9.
go back to reference Branson R, Armstrong D: General practitioners' perceptions of sharing workload in group practices: qualitative study. BMJ. 2004, 329: 381-383. 10.1136/bmj.38173.532465.7C.CrossRefPubMedPubMedCentral Branson R, Armstrong D: General practitioners' perceptions of sharing workload in group practices: qualitative study. BMJ. 2004, 329: 381-383. 10.1136/bmj.38173.532465.7C.CrossRefPubMedPubMedCentral
11.
go back to reference Delansorne F, Buis H, Robino S, Tomas J, Huez J-F, Fanello F: Early suspension of private practice: the current trends for general practitioners in three counties in Western France. Sante Publique. 2009, 21: 375-382.PubMed Delansorne F, Buis H, Robino S, Tomas J, Huez J-F, Fanello F: Early suspension of private practice: the current trends for general practitioners in three counties in Western France. Sante Publique. 2009, 21: 375-382.PubMed
12.
go back to reference Glaser B, Strauss A: The discovery of grounded theory: Strategies for qualitative research. 1967, Chicago: Aldine Publishing Glaser B, Strauss A: The discovery of grounded theory: Strategies for qualitative research. 1967, Chicago: Aldine Publishing
13.
go back to reference NVivo qualitative data analysis software, version 9. 2010, Doncaster: QSR International Pty Ltd NVivo qualitative data analysis software, version 9. 2010, Doncaster: QSR International Pty Ltd
15.
go back to reference McKevitt C, Morgan M, Hudson M: Locum doctors in general practice: motivation and experiences. Br J Gen Pract. 1999, 49: 519-521.PubMedPubMedCentral McKevitt C, Morgan M, Hudson M: Locum doctors in general practice: motivation and experiences. Br J Gen Pract. 1999, 49: 519-521.PubMedPubMedCentral
16.
go back to reference Myhre DL, Konkon J, Woloschuk W, Szafran O, Hansen C, Crutcher L: Locum practice by recent family medicine graduates. Can Fam Physician. 2010, 56: 183-190. Myhre DL, Konkon J, Woloschuk W, Szafran O, Hansen C, Crutcher L: Locum practice by recent family medicine graduates. Can Fam Physician. 2010, 56: 183-190.
18.
go back to reference Iliff D: Solo Practice: The way of the future. Fam Pract Manag. 2003, 10: 23-27.PubMed Iliff D: Solo Practice: The way of the future. Fam Pract Manag. 2003, 10: 23-27.PubMed
19.
go back to reference Tallia AF, Lanham HJ, Mc Daniel RR, Crabtree BF: Seven characteristics of successful work relationships. Fam Pract Manag. 2006, 13: 47-50.PubMed Tallia AF, Lanham HJ, Mc Daniel RR, Crabtree BF: Seven characteristics of successful work relationships. Fam Pract Manag. 2006, 13: 47-50.PubMed
23.
go back to reference Newton J, Eccles MP, Soutter J: General practice partnerships: an exploratory review. J Manag Med. 1996, 10: 62-71. 10.1108/02689239610117843.CrossRefPubMed Newton J, Eccles MP, Soutter J: General practice partnerships: an exploratory review. J Manag Med. 1996, 10: 62-71. 10.1108/02689239610117843.CrossRefPubMed
26.
go back to reference Newton J, Eccles MP, Soutter J: Can we understand partnerships in general practice? A pilot study. Fam Pract. 1996, 13: 152-155. 10.1093/fampra/13.2.152.CrossRefPubMed Newton J, Eccles MP, Soutter J: Can we understand partnerships in general practice? A pilot study. Fam Pract. 1996, 13: 152-155. 10.1093/fampra/13.2.152.CrossRefPubMed
27.
go back to reference MacIed J: Appointment and mobility of general practitioners. BMJ. 1987, 294: 1265-1266. 10.1136/bmj.294.6582.1265.CrossRef MacIed J: Appointment and mobility of general practitioners. BMJ. 1987, 294: 1265-1266. 10.1136/bmj.294.6582.1265.CrossRef
28.
go back to reference Safford B: Manning C. Six characteristics of effective practice teams. Fam Pract Manag. 2012, 19: 26-30.PubMed Safford B: Manning C. Six characteristics of effective practice teams. Fam Pract Manag. 2012, 19: 26-30.PubMed
29.
go back to reference Snowise N: Changing partnership. BMJ. 1997, 314: S2-7086. Snowise N: Changing partnership. BMJ. 1997, 314: S2-7086.
Metadata
Title
When the group practice breaks up: a qualitative study
Authors
François Marechal
Dorothée Schmidt
Evelyne Lasserre
Laurent Letrilliart
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2013
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-14-53

Other articles of this Issue 1/2013

BMC Primary Care 1/2013 Go to the issue