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当团体实践解散时:一项定性研究。

When the group practice breaks up: a qualitative study.

机构信息

Département de médecine générale, Université Claude Bernard Lyon 1, 8 avenue Rockefeller, Lyon Cedex 08 69373, France.

出版信息

BMC Fam Pract. 2013 May 3;14:53. doi: 10.1186/1471-2296-14-53.

Abstract

BACKGROUND

Group practices are increasingly common for primary care physicians worldwide. Although breakups are likely to happen frequently within group practices, their process has not been studied to date. The aims of this study were therefore to explore the reasons for breakups of group practices of general practitioners and to describe the associated feelings.

METHODS

We conducted a qualitative study consisting of in-depth interviews of 21 general practitioners and one secretary from past group practices in the Rhône-Alpes region, France, who experienced a breakup.

RESULTS

When getting started in group practice for the first time, young doctors did not feel ready and supported, and did not necessarily share the same expectations as their partners. The reasons for the breakups involved imbalances within the groups, contrasting working and management styles, and breakdowns in communication. The breakup process often generated long-persistent feelings of suffering and failure for almost every partner who experienced a breakup, particularly for the partner who was leaving.

CONCLUSIONS

Weakening factors exist from the very beginning of a partnership, and problems are likely to increase at every change or event occurring in the group. We provide several recommendations, including fair management, a shared project based on a precise contract, the consultation of third parties as necessary and, in the worst case scenario, leaving the group practice in time.

摘要

背景

团体执业在全球范围内的基层医疗医师中越来越普遍。尽管团体执业中可能经常会出现分裂,但迄今为止,其过程尚未得到研究。因此,本研究旨在探讨全科医生团体执业分裂的原因,并描述相关感受。

方法

我们进行了一项定性研究,对来自法国罗纳-阿尔卑斯地区过去的团体执业中的 21 名全科医生和 1 名秘书进行了深入访谈,这些人都经历过团体执业的分裂。

结果

初次开始团体执业时,年轻医生感到没有准备和支持,并不一定与他们的合作伙伴有相同的期望。分裂的原因涉及团体内部的不平衡、工作和管理风格的差异,以及沟通的破裂。分裂过程常常给几乎每一个经历过分裂的合作伙伴带来持久的痛苦和失败感,对于即将离开的合作伙伴来说尤其如此。

结论

从伙伴关系的一开始就存在削弱因素,而且在团体中发生的每一次变化或事件都可能增加问题。我们提出了一些建议,包括公平管理、基于明确合同的共同项目、必要时咨询第三方,以及在最坏的情况下及时离开团体执业。

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