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Open Access Research article

When the group practice breaks up: a qualitative study

François Marechal1, Dorothée Schmidt1, Evelyne Lasserre2 and Laurent Letrilliart1*

Author affiliations

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

2 S2HEP, Université Claude Bernard Lyon 1 & ENS Lyon 43, Boulevard du 11 Novembre 1918, Villeurbanne Cedex 69373, France

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Citation and License

BMC Family Practice 2013, 14:53  doi:10.1186/1471-2296-14-53

Published: 3 May 2013

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.

Keywords:
Practice breakup; Group practice; Partnership; General practice; Suffering at work; Contract