transition projectdr. c. van boven doctors working together in practice saturday 4th july 2009 –...

Transition project Dr. 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


Presentation

Transition Project, history

Core qualities

Group Practice pros and cons

The opinion of the Patient

Data from the Dutch Transition Project

Conclusions


Transition project

History

Transition project History Dr. C. van Boven

Transition project Dr. C. van BovenTransition project History

Transition project Dr. C. van BovenTransition project History

The Transhis group

Dr. C. van Boven

Episode of care, example

Process

HbProcess

Hb

Processcolonoscopy

Processcolonoscopy

Process

referral,advice

Process

referral,advice

RFE‘I’m feeling

tired’

RFE‘I’m feeling

tired’

Diagnosis

tiredness

Diagnosis

tiredness

RFE‘what’s thetest result?’


Diagnosisiron deficiency

anemia

Diagnosisiron deficiency

anemia

Diagnosis

Ca colon

Diagnosis

Ca colon



2nd encounter

3rd encounter

Transition project History


Core qualities

Transition project Dr. C. van BovenTransition project core quality

Embrace the diversity

Dr. C. van BovenTransition project core quality

Expressing Humanism

Transition project core quality Dr. C. van Boven

The importance of epidemiology


Group Practice

pros and cons

Dr. C. van Boven

Let me be clear

You ‘llwork togetherwith 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 samenHuisarts en Wetenschap, jaargang 2007, nummer 5:185-185


Dr. C. van Boven

Pros


Differentiation of tasks



Dr. C. van Boven

Pros



Cost-efficiency, support staff and medical equipment



Dr. C. van Boven

Pros




Direct feed-back



Dr. C. van Boven

Pros




Direct feed-back

Patient: choice of different providers



Dr. C. van Boven

Let me be clear

You ‘llwork togetherwith me


Dr. C. van Boven

Not the

reverse


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 difficultLamberts H. Samenwerken in een team - een routebeschrijving door een ruig

landschap. Huisarts Wet 1974;17:15-23.



The opinion of the Patient

Transition project The opinion of the Patient Dr. 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 Patient Dr. 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 = 159 Patient N = 1124

% %

Competent, professional experienced 50 39

Listening ear, interested, empathitic 13 37

Reliable confidant, trustee 15 25

Kind, friendly, sympathatic 9 24

Accessible, nearby, present 25 17

Takes time 6 15

Interested, attentive 5 11

Apprehensible 3 8

Good communication, good advise/explaining 12 7

Helpful, careful 2 7

No waiting period, fastl 4 7

Involved, dedicated 34 1

De huisarts-patiëntrelatie anno 2006Sietske Lems TSN NIPO E4875 | oktober 2006 Nederlands Huisartsen Genootschap (NHG)

Transition project The opinion of the Patient


Data

from

the Dutch Transition project

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

Dr. C. van Boven

face to face encounters per age group

0% 20% 40% 60% 80% 100%

AG

ES

AH

MW

PD

GP

JH

TP

KB

HAIO

0-24y

25-44y

45-64y

65-74y

74+y

Transition project Data from the Dutch Transition project

Dr. C. van Boven

% face to face encounters per age group

0% 20% 40% 60% 80% 100%

AG

ES

AH

MW

PD

GP

FR

0-24y

25-44y

45-64y

65-74y

74+y


Dr. C. van Boven

Diagnosis GP and trainee in one practice 2000-2009

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

KB

HAIO

General

Blood

Digestive

Eye

Ear

Circulatory

Musculoskeletal

Neurological

Psychological

Respiratory

Skin

Endocrine, metabolic and nutritional

Urinary system

Pregnancy, family planning

Female genital system, including breast

Male genital system

Social problems


Diagnosis per chapter per GP 2000-2009

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

AG/ES

Fr

MW

AH

PD

GP

General

Blood

Digestive

Eye

Ear

Circulatory

Musculoskeletal

Neurological

Psychological

Respiratory

Skin

Endocrine, metabolic and nutritional

Urinary system

Pregnancy, family planning

Female genital system, including breast

Male genital system

Social problems

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


Conclusions

Transition project Conclusions Dr. C. van Boven

conclusions

Cooperation expands your diagnostic and therapeutic possibilities


conclusions


Care will be more patient-friendly


conclusions



Care will be more efficient


conclusions




Cooperation offer more opportunities to work flexible hours (parttime)


conclusions




Cooperation offer more opportunities to work flexible hours (parttime)

Cooperation is fun!


Women

want

group practices


Young practitioners

don’t want

to work alone

Dr. C. van BovenTransition project Conclusions

1 and 1 > 2

groupduosolo


transition projectdr. c. van boven doctors working together in practice saturday 4th july 2009 –...

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