“Gaining control through close collaboration” – GPs’ experiences of a Collaborative Care Model for patients with Common Mental Disorders who need sick leave certification

Ausra Saxvik, Irene Svenningsson, Karin Törnbom, Eva-Lisa Petersson, Cecilia Björkelund, Goda Gabartaite, Dominique Hange

Keywords: Primary health care; General Practitioner; Common mental disorders; Collaborative care; Care manager

Background:

General Practitioners (GPs) are an important part of collaboration around patients with common mental disorders in primary care. To further improve collaboration, the model Co-Work-Care was implemented, which emphasised working more closely with patients through active dialogues among care managers, rehabilitation coordinators and GPs. This enhanced collaborative model also included a person-centred dialogue meeting with patients’ employers.

Research questions:

To explore GPs’ experiences of the Co-Work-Care model – a collaborative care organisation at the primary care centre including a person-centred dialogue meeting in the care of patients with common mental disorders who need sick leave certification.

Method:

Design and setting: Qualitative individual and group interviews among Swedish GPs with experience of the Co-Work-Care trial where the primary care centre (PCC) was an intervention PCC with the enhanced collaboration model.
Method: GPs were sampled purposefully from different Co-Work-Care intervention PCCs in Sweden. Focus group and individual in-depth semi-structured interviews were conducted. All interviews were analysed by Systematic Text Condensation according to Malterud.

Results:

Three codes describing the GPs’ experiences of working in the Co-Work-Care model were identified: 1) A structured work approach, 2) Competency of the care manager and the rehabilitation coordinator, and 3) Gaining control through close collaboration.

Conclusions:

GPs experienced that the enhanced collaboration reduced their workload and enabled them to focus on the medical care. Patient care was perceived as safer and more effective. These advantages may result in higher quality in medical and rehabilitation decisions, as well as a more sustainable and less stressful work situation for GPs.

Points for discussion:

How does it fit in the different primary care organisations in other countries?

What’s in it for the doctor?

More job, higher costs, no control?

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