1. 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

2. Henk Lamberts

3. 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

4. Transition projectDr. C. van Boven Transition project History

5. Transition project HistoryDr. C. van Boven

6. Transition projectDr. C. van BovenTransition project History

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

8. 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

9. Transition projectDr. C. van Boven Core qualities

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

11. Dr. C. van BovenTransition project core quality Expressing Humanism

12. Dr. C. van BovenTransition project core quality Expressing Humanism

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

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

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

16. 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 5:185-185 Transition project Pros and Cons

17. 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 5:185-185 Transition project Pros and Cons

18. 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 5:185-185 Transition project Pros and Cons

19. 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 5:185-185 Transition project Pros and Cons

20. 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 5:185-185 Transition project Pros and Cons

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

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

23. 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 3:114-116 Collaboration is difficult Lamberts H. Samenwerken in een team - een routebeschrijving door een ruig landschap. Huisarts Wet 1974;17:15-23. Transition project Pros and Cons

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

25. 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)

26. 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)

27. 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

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

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

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

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

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

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

34. Transition projectDr. C. van Boven Conclusions

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

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

37. 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

38. 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)

39. 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!

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

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

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

43. Transition projectDr. C. van Boven

44. Transition projectDr. C. van Boven

45. Transition projectDr. C. van Boven

46. Transition projectDr. C. van Boven

47. group duo solo Transition projectDr. C. van Boven