Competencies for collaboration between general practitioners and medical specialists: a qualitative study of the patient perspective

Marijn Janssen; Cornelia R M G Fluit; Margaretha H Sagasser; Loes H J Kusters; Nynke D Scherpbier-de Haan; Jacqueline de Graaf

doi:10.1136/bmjopen-2020-037043

Competencies for collaboration between general practitioners and medical specialists: a qualitative study of the patient perspective

BMJ Open. 2020 Jul 1;10(7):e037043. doi: 10.1136/bmjopen-2020-037043.

Authors

Marijn Janssen¹, Cornelia R M G Fluit², Margaretha H Sagasser³, Loes H J Kusters⁴, Nynke D Scherpbier-de Haan⁵, Jacqueline de Graaf^{6

2}

Affiliations

¹ Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands marijn.janssen@radboudumc.nl.
² Radboudumc Health Academy, Radboudumc, Nijmegen, The Netherlands.
³ Network of GP Specialty Training Institute in The Netherlands, Utrecht, The Netherlands.
⁴ Dutch Training Programme for Specialists in Elderly Care, Utrecht, The Netherlands.
⁵ Primary and Community Care, Radboudumc, Nijmegen, The Netherlands.
⁶ Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands.

Abstract

Objectives: To explore the patient view of competencies essential for doctors to provide good collaboration at the primary-secondary care interface.

Design: We used a qualitative research approach. Focus groups with patients were conducted to explore their opinions of doctors' competencies to provide good collaboration between primary and secondary care doctors. Transcripts were analysed using thematic analysis.

Setting: Dutch primary-secondary care interface.

Participants: Sixteen participants took part in five focus groups. Patients treated in both primary and secondary care, defined as having a minimum of two contacts with their general practitioner and two contacts with a medical specialty in the last 6 months, were included. Psychiatric patients and children were excluded from this study.

Results: Three groups of competencies were identified: (1) relationship building, both with patients and with other doctors; (2) transparent collaborating: be able to provide clarity on the process of collaboration and on roles and responsibilities of those involved and (3) reflective practising: to be willing to acknowledge mistakes, give and receive feedback and act as a lifelong learner.

Conclusions: This focus group study enhances our understanding of the patient perspective on doctors' collaborative competencies at the primary-secondary care interface. With this information, doctors can improve their collaborative skills to a level that would meet their patients' needs. Patients expect doctors to be able to build relationships and act as reflective practitioners. Including patients in the collaborative process by giving them a role that is appropriate to their abilities and by making collaboration more explicit could help to improve collaboration between general practitioners and medical specialists.

Keywords: medical education & training; organisation of health services; primary care; qualitative research.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
General Practitioners*
Humans
Medicine*
Middle Aged
Primary Health Care
Qualitative Research
Specialization
Young Adult