Modifiable determinants for the success or failure of inter-physician collaboration in group practices in Germany - a qualitative study

BACKGROUND: A growing demand for physicians exists worldwide. Due to political changes, economic incentives and new workplace expectations a trend from single-handed practices to group practices has been noticed in many countries over the last years. In view of this background, our study aimed to identify determinants for success or failure of inter-physician collaboration in order to positively influence future collaboration in anticipation of the important role group practices may play in future health care delivery. METHODS: We chose a qualitative study design, using semi-structured phone interviews to collect data from physicians and non-physician consultants with experience in inter-physician collaboration that were analysed using content analysis. Eleven physicians with experience in collaborative working and fourteen non-physician consultants specializing in advice to health care professionals participated. RESULTS: Education in entrepreneurial skills as well as implementation of good practice management in preparation for collaboration are crucial modifiable facilitators for successful inter-physician collaboration. Furthermore, open communication and realistic insight into the mode of acquaintance, moral concept and degree of specialisation of the colleagues involved play major roles for the success of inter-physician collaboration in group practices. CONCLUSIONS: There are several underlying themes beyond clinical expertise concerning success or failure of group practices. To influence future collaboration positively, it is important to focus on management and communication skills as well as to address basic understanding of economics.