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. 2018 Mar 10;19(1):40.
doi: 10.1186/s12875-018-0726-5.

The role of the general practitioner in multidisciplinary teams: a qualitative study in elderly care

Sietske M Grol  1 , Gerard R M Molleman  2   3 , Anne Kuijpers  2 , Rob van der Sande  4 , Gerdine A J Fransen  2   3 , Willem J J Assendelft  2 , Henk J Schers  2
Affiliations

The role of the general practitioner in multidisciplinary teams: a qualitative study in elderly care

Sietske M Grol et al. BMC Fam Pract. .

Abstract

Background: In the western world, a growing number of the older people live at home. In the Netherlands, GPs are expected to play a pivotal role in the organization of integrated care for this patient group. However, little is known about how GPs can play this role best. Our aim for this study was to unravel how GPs can play a successful role in elderly care, in particular in multidisciplinary teams, and to define key concepts for success.

Methods: A mixed qualitative research model in four multidisciplinary teams for elderly care in the Netherlands was used. With these four teams, consisting of 46 health care and social service professionals, we carried out two rounds of focus-group interviews. Moreover, we performed semi-structured interviews with four GPs. We analysed data using a hybrid inductive/deductive thematic analysis.

Results: According to the health care and social service professionals in our study, the role of GPs in multidisciplinary teams for elderly care was characterized by the ability to 'see the bigger picture'. We identified five key activities that constitute a successful GP role: networking, facilitating, team building, integrating care elements, and showing leadership. Practice setting and phase of multidisciplinary team development influenced the way in which GPs fulfilled their roles. According to team members, GPs were the central professionals in care services for older people. The opinions of GPs about their own roles were diverse.

Conclusions: GPs took an important role in successful care settings for older people. Five key concepts seemed to be important for best practices in care for frail older people: networking (community), facilitating (organization), team building (professional), integrating care elements (patient), and leadership (personal). Team members from primary care and social services indicated that GPs had an indispensable role in such teams. It would be advantageous for GPs to be aware of this attributed role. Attention to leadership competencies and to the diversity of roles in multidisciplinary teams in GP training programmes seems useful. The challenge is to convince GPs to take a lead, also when they are not inclined to take this role in organizing multidisciplinary teams for older people.

Keywords: Focus groups; Frail older people; General practitioner; Integrated health care systems; Leadership; Multidisciplinary team meetings; Qualitative research.

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Conflict of interest statement

Authors’ information

SG: MSc, researcher, Department of Primary and Community Care and policy advisor integrated care, Corporate Staff Strategy Development, Radboud University Medical Center, Nijmegen, NL. GM: PhD, researcher, manager healthy living, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen and Community Health Service Gelderland-Zuid, Department of Healthy Living, Nijmegen, NL. AK: BSc, researcher, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, NL. RS, PhD, professor primary and community care. Lectureship of primary and community care, Han University of Applied Sciences, Nijmegen, NL. GF: PhD, researcher, team manager healthy community. Department of Primary and Community Care, Radboud University Medical Center, Nijmegen and Community Health Service Gelderland-Zuid, Department of Healthy Living, Nijmegen, NL. WA: MD, PhD, professor in general practice, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, NL. HS: MD, PhD, researcher and GP. Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, NL.

Ethics approval and consent to participate

None required, according to the Arnhem and Nijmegen Research Ethics Committee (file number 2017-3516). According to the Committee, the respondents in our research were not subjected to any actions or behaviour that indicated that the research should be considered as a research under the Medical Research Act (WMO [Wet Medisch Onderzoek]). Therefore, it was not necessary for the CMO region Arnhem–Nijmegen or another recognized review committee to make a positive assessment. The participants signed an informed consent form to be included in this study.

Consent for publication

All participants gave written consent for the use of anonymized quotations from the focus-group discussions in presentations and publications arising from the research.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

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Fig. 1
Time line of the PRECURO participatory action research
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