Optimizing cooperation between general practitioners, occupational health and rehabilitation physicians in Germany: a qualitative study

PURPOSE: To achieve successful medical rehabilitation and timely return to work, general practitioners, occupational health and rehabilitation physicians need to cooperate effectively. This cooperation, however, can be hampered by organizational, interpersonal, and structural barriers. In this article, we present and discuss suggestions proposed by physicians and patients on how these barriers can be overcome. METHODS: We conducted eight qualitative focus group discussions with general practitioners (GPs), occupational health physicians (OPs), rehabilitation physicians (RPs) and rehabilitation patients, which we analyzed with qualitative content analysis methods. RESULTS: Room for improvement exists with regard to (1) regulation (e.g. formalized role and obligatory input of occupational physicians), (2) finance (e.g. financial incentives for physicians based on the quality of the application), (3) technology (e.g. communication by email), (4) organizational procedures (e.g. provision of workplace descriptions to RPs on a routine basis), (5) education and information (e.g. joint educational programs, measures to improve the image of OPs), and (6) promotion of cooperation (e.g. between OPs and GPs in regards to the application process). CONCLUSIONS: Many suggestions are practical and could be implemented into the daily routine of physicians, while others demand multi-level, multi-stakeholder approaches. Our findings are supported by numerous international studies (especially from Western Europe). Future quantitative research could assess the relative weight of these findings. Feasibility and effectiveness of the proposed suggestions should be tested in controlled interventional studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00420-017-1239-6) contains supplementary material, which is available to authorized users.