Partnership in medicine: how to promote the collaboration between general practitioners, occupational physicians and social insurance physicians?

Introduction
Many situations justify a close collaboration between GP, OP and SIP. Health problems impact work activity and vice versa. An altered health situation confronts workers with the risk of exclusion from the labour market. An interprofessional collaboration is thus needed to promote a more active policy of rehabilitation of workers on long term sickness absence.
The Belgian Ministry of Employment initiated this study to identify communication channels and tools that could support collaboration among those health professionals.

Methods
To this purpose, 8 nominal groups were organised to think about proposals to improve interdisciplinary collaboration. In sum 42 GP’s, 16 OP’s and 16 SIP’s participated in the discussions. For the elaboration of the final proposals, the research team relied on a multidisciplinary expert group.

Results
An asymmetric relation was observed; each group expressed the need to receive information from the two others, but proposals to transfer information were rare. Exchanges in the groups showed that reciprocal ignorance is important and communication modalities are poor. A profound revision of the information transmission procedures seemed necessary. Several practical proposals were made to improve communication in case of sickness absence over three months, to allow information transfer and to promote mutual respect between the three disciplines. Other proposals considered professional training, and professional competencies which need to be better defined.

Discussion
Misconceptions of the role of the different professional disciplines form a barrier to an effective collaboration. Technical and regulatory measures alone will not bring about a real promotion of interdisciplinary collaboration. The proposals arising from the study will contribute to increase reciprocal knowledge between professionals from the three disciplines and thus form the basis of a more effective collaboration. In turn, the experience of collaboration could have a beneficial effect on the reciprocal representations of each partner role.