“We talk it over” - mixed-method study of interdisciplinary collaborations in private practice among urologists and oncologists in Germany

Abstract

BackgroundUtilisation of multidisciplinary teams is considered the best approach to care and treatment for cancer patients. However, the multidisciplinary approach has mainly focused on inpatient care rather than routine outpatient care. The situation in private practice care and outpatient care is gradually changing. We aimed to 1), investigate interdisciplinary cooperations in the care of tumor patients among urologists and oncologists in the community setting, 2), establish an estimate of the prevalence of cooperation among oncologists and organ-specific providers in community settings in Germany and 3), characterise existing cooperations among oncologists and urologists.MethodsWe conducted simultaneously a cross-sectional survey with private practice urologists (n = 1,925) and a qualitative study consisting of semi-structured interviews with urologists and oncologists (n = 42), primarily with private practices, who had indicated cooperation the care of urological tumor patients.ResultsMost of the participants (66%) treated their own tumor patients. When physicians referred patients, they did so for co- and subsequent treatments (43%). Most cooperating urologists were satisfied with the partnership and appreciated the competency of their partners. Qualitative interviews revealed two types of collaboration in the community setting: formal and informal. Collaborations were usually ongoing with many physicians and depended equally on both patient preference and diagnosis.ConclusionJoint patient treatment requires clear delineation of roles and responsibilities and simple means of communication. Formal frameworks should allow for incorporation of patients’ critical role in collaboration decisions in treatment and care.

Physician cooperation in outpatient cancer care. An amplified secondary analysis of qualitative interview data

“…In a study on GPs' involvement in cancer care in Germany (OHa-Oncology in General Practice), we also found slow or non-existent information sharing to be an issue (Dahlhaus, Vanneman, Guethlin, Behrend, & Siebenhofer, 2014). In a study on the cooperation of urologists and oncologists (IBuTu-Interdisciplinary Health Care of Urological Tumours), we found that both formal and informal cooperation structures were considered important for a well-functioning cooperation relationship (Beermann, Chakkalakal, Muckelbauer, Weißbach, & Holmberg, 2014).…”

“…This has been shown to be the case across different health care systems, such as in the US (Gandhi et al, 2000;Shen et al, 2015), Australia (Jefford et al, 2008;Lizama et al, 2015) and UK (Farquhar et al, 2005). In a study on the cooperation of urologists and oncologists (IBuTu-Interdisciplinary Health Care of Urological Tumours), we found that both formal and informal cooperation structures were considered important for a well-functioning cooperation relationship (Beermann, Chakkalakal, Muckelbauer, Weißbach, & Holmberg, 2014). In a study on the cooperation of urologists and oncologists (IBuTu-Interdisciplinary Health Care of Urological Tumours), we found that both formal and informal cooperation structures were considered important for a well-functioning cooperation relationship (Beermann, Chakkalakal, Muckelbauer, Weißbach, & Holmberg, 2014).…”

“…We conducted an amplified secondary analysis (Heaton, 2008) that combined the data sets of two independent projects: IBuTu-Interdisciplinary Health Care of Urological Tumours (Beermann et al, 2014) and OHa-Oncology in General Practice (Dahlhaus, Behrend, et al, 2013;Dahlhaus, Vanneman, et al, 2013;Dahlhaus et al, 2014).…”

“…Qualitative, semi-structured, face-to-face interviews with urologists and oncologists were conducted in 2012 (Beermann et al, 2014). Qualitative, semi-structured, face-to-face interviews with urologists and oncologists were conducted in 2012 (Beermann et al, 2014).…”

“…The IBuTu project was located at the Institute of Public Health at Charité-Universitätsmedizin Berlin and aimed to assess current practices of cooperation among oncologists and urologists in outpatient settings in Germany. Qualitative, semi-structured, face-to-face interviews with urologists and oncologists were conducted in 2012 (Beermann et al, 2014). The interview guidelines included questions regarding the type and organisation of practice, cooperation with other physicians, as well as barriers to and enabling factors for these cooperations.…”