Moving towards multidisciplinary primary care collaboration.

Background: In Europe, many primary care professionals were traditionally organized in small-scaled practices. Nowadays, they are working more often in larger practices. This applies to general practitioners, but also to other professions, such as midwives or physical therapists. In addition, primary care professions are teaming up in multidisciplinary practices more and more, which should improve collaboration and coordination within the wider scope of primary care. In this study we investigate the extend to which general practitioners share a practice location or collaborate with various other primary care professions, and which conditions affect the chances of multidisciplinary collaboration in primary care. Methods: We sent a questionnaire to general practitioners in all 4300 registered general practices in the Netherlands, of whom 76% responded. The questionnaire contained questions concerning the general practitioners working in those practices, their collaboration with other disciplines and an inventory of any additional services the practice might provide, such as opening hours during night time, e-mail consults etc. Results: Preliminary results show that being located in the same building or practice relates to more collaboration between the general practitioner and other disciplines. This interconnectedness is stronger for some disciplines than for others. Also, differences occur in the types of practices that employ such linkages. For example, larger scale practices work more often with other disciplines than solitary working general practitioners. Currently, we are investigating whether characteristics such as age and practice innovations are related to multidisciplinary collaboration. Conclusions: The possibilities for collaboration appear to be growing, partly because of the longer trend towards scale enlargement of general practices, but also because these developments are part of an increasing policy approach, in which the position of primary care is reinforced, enabling it to maintain its central role in the healthcare system