Transition projectDr. C. van Boven Doctors working together in practice Saturday 4th July 2009 – MIPC Annual Conference “Inter-doctor variation” in Family Medicine Kees van Boven, general practitioner

Henk Lamberts

Transition projectDr. C. van Boven Presentation Transition Project, history Core qualities Group Practice pros and cons The opinion of the Patient Data from the Dutch Transition Project Conclusions

Transition projectDr. C. van Boven Transition project History

Transition project HistoryDr. C. van Boven

Transition projectDr. C. van BovenTransition project History

Transition projectDr. C. van BovenTransition project History The Transhis group

Dr. C. van Boven Episode of care, example Process Hb Process Hb Process colonoscopy Process colonoscopy Process referral, advice Process referral, advice RFE ‘I’m feeling tired’ RFE ‘I’m feeling tired’ Diagnosis tiredness Diagnosis tiredness RFE ‘what’s the test result?’ RFE ‘what’s the test result?’ Diagnosis iron deficiency anemia Diagnosis iron deficiency anemia Diagnosis Ca colon Diagnosis Ca colon RFE ‘what’s the test result?’ RFE ‘what’s the test result?’ 2 nd encounter 3 rd encounter Transition project History

Transition projectDr. C. van Boven Core qualities

Transition projectDr. C. van BovenTransition project core quality Embrace the diversity

Dr. C. van BovenTransition project core quality Expressing Humanism

Dr. C. van BovenTransition project core quality Expressing Humanism

Transition project core qualityDr. C. van Boven The importance of epidemiology

Transition projectDr. C. van Boven Group Practice pros and cons

Dr. C. van Boven Let me be clear You ‘ll work together with me Transition project Pros and Cons

Dr. C. van Boven Pros Flexible working hours Jabaaij L, Hingstmann L. Alleen is maar alleen: huisartsen steeds vaker samen Huisarts en Wetenschap, jaargang 2007, nummer 5: Transition project Pros and Cons

Dr. C. van Boven Pros Flexible working hours Differentiation of tasks Jabaaij L, Hingstmann L. Alleen is maar alleen: huisartsen steeds vaker samen Huisarts en Wetenschap, jaargang 2007, nummer 5: Transition project Pros and Cons

Dr. C. van Boven Pros Flexible working hours Differentiation of tasks Cost-efficiency, support staff and medical equipment Jabaaij L, Hingstmann L. Alleen is maar alleen: huisartsen steeds vaker samen Huisarts en Wetenschap, jaargang 2007, nummer 5: Transition project Pros and Cons

Dr. C. van Boven Pros Flexible working hours Differentiation of tasks Cost-efficiency, support staff and medical equipment Direct feed-back Jabaaij L, Hingstmann L. Alleen is maar alleen: huisartsen steeds vaker samen Huisarts en Wetenschap, jaargang 2007, nummer 5: Transition project Pros and Cons

Dr. C. van Boven Pros Flexible working hours Differentiation of tasks Cost-efficiency, support staff and medical equipment Direct feed-back Patient: choice of different providers Jabaaij L, Hingstmann L. Alleen is maar alleen: huisartsen steeds vaker samen Huisarts en Wetenschap, jaargang 2007, nummer 5: Transition project Pros and Cons

Dr. C. van Boven Let me be clear You ‘ll work together with me Transition project Pros and Cons

Dr. C. van Boven Not the reverse Transition project Pros and Cons

Dr. C. van Boven Contras Loss of a part of the Personal Continuity Care. Heath I. Humanity and continuity. Huisarts en Wet, jaargang 2007, nummer 3: Collaboration is difficult Lamberts H. Samenwerken in een team - een routebeschrijving door een ruig landschap. Huisarts Wet 1974;17: Transition project Pros and Cons

Transition projectDr. C. van Boven The opinion of the Patient

Transition project The opinion of the PatientDr. C. van Boven Familiarity with a GP improves patients' assessment of GP care. Also in the future, personal continuity should be promoted. Familiarity with a GP and patients' evaluations of care. A cross-sectional study. Schers H, van den Hoogen H, Bor H, Grol R, van den Bosch W The view of the patient (1)

Transition project The opinion of the PatientDr. C. van Boven The added value of interpersonal continuity had to be combined with recognition. Frederiksen HB, Kragstrup J, Dehlholm-Lambertsen G. It's all about recognition! Qualitative study of the value of interpersonal continuity in general practice. BMC Family Practice 2009, 10:47 The view of the patient (2)

Dr. C. van Boven Keywords perfect GP (voluntarily, 3 answers in all, most given answers) GP N = 159Patient N = 1124 % Competent, professional experienced 5039 Listening ear, interested, empathitic1337 Reliable confidant, trustee1525 Kind, friendly, sympathatic 924 Accessible, nearby, present2517 Takes time 615 Interested, attentive 511 Apprehensible 38 Good communication, good advise/explaining127 Helpful, careful 27 No waiting period, fastl 47 Involved, dedicated341 De huisarts-patiëntrelatie anno 2006 Sietske Lems TSN NIPO E4875 | oktober 2006 Nederlands Huisartsen Genootschap (NHG) Transition project The opinion of the Patient

Transition projectDr. C. van Boven Data from the Dutch Transition project

Dr. C. van Boven Transition project Data from the Dutch Transition project

Dr. C. van BovenTransition project Data from the Dutch Transition project

Dr. C. van BovenTransition project Data from the Dutch Transition project

Dr. C. van BovenTransition project Data from the Dutch Transition project

Dr. C. van BovenTransition project Data from the Dutch Transition project

Transition projectDr. C. van Boven Conclusions

Transition project ConclusionsDr. C. van Boven conclusions Cooperation expands your diagnostic and therapeutic possibilities

Transition project ConclusionsDr. C. van Boven conclusions Cooperation expands your diagnostic and therapeutic possibilities Care will be more patient-friendly

Transition project ConclusionsDr. C. van Boven conclusions Cooperation expands your diagnostic and therapeutic possibilities Care will be more patient-friendly Care will be more efficient

Transition project ConclusionsDr. C. van Boven conclusions Cooperation expands your diagnostic and therapeutic possibilities Care will be more patient-friendly Care will be more efficient Cooperation offer more opportunities to work flexible hours (parttime)

Transition project ConclusionsDr. C. van Boven conclusions Cooperation expands your diagnostic and therapeutic possibilities Care will be more patient-friendly Care will be more efficient Cooperation offer more opportunities to work flexible hours (parttime) Cooperation is fun!

Transition project ConclusionsDr. C. van Boven Women want group practices

Transition project ConclusionsDr. C. van Boven Young practitioners don’t want to work alone

Dr. C. van BovenTransition project Conclusions 1 and 1 > 2

Transition projectDr. C. van Boven

Transition projectDr. C. van Boven

Transition projectDr. C. van Boven

Transition projectDr. C. van Boven

group duo solo Transition projectDr. C. van Boven