Nieuwe wegen naar arbocuratieve samenwerking: samen werken van praktijkondersteuners huis- en bedrijfsarts bij multiproblematiek

Background: To this date, there is little to no interprofessional collaboration between professionals in general and occupational health care in the Netherlands. Where earlier initiatives for improvement focused on general practitioners (GPs) and occupational physicians (OPs), we examine the role that professionals working under task delegation of GPs and OPs can play in addressing problems on multiple life domains as well as in interprofessional collaboration. Methods: We conducted three focus group interviews with 7 assistant practitioners (APs) in general practice, 11 practice nurses (PNs) in general practice and 8 APs in occupational health practice. Results: All PNs and APs in our study are confronted with multi-domain problems and see a role for themselves in addressing these problems. Moreover, in case of multi-domain problems, they acknowledge the relevance of interprofessional collaboration to provide good care. At this moment, however, there is practically no collaboration at the level of PNs and APs. Challenges are found in the formal task delegation and role identity of the APs in occupational health practice, unfamiliarity and prejudices among especially general practice PNs and APs regarding occupational health care, and practical barriers as privacy laws and reachability. Conclusion: Interprofessional collaboration among PNs and APs in general and occupational health care is possible, provided that a solution is found for fundamental and practical challenges. Potential solutions are to shift the focus from sharing medical information to communicating about the needs of working patients to function healthily on multiple life domains, to address interprofessional collaboration in educations, to adapt consultation protocols to include work and to organize joint meetings between professionals in general and occupational health practice. Finally, addressing structural barriers such as privacy laws and financing requires political action.