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Table 2 Code tree

From: The introduction of advanced practice physiotherapy within Dutch primary care is a quest for possibilities, added value, and mutual trust: a qualitative study amongst advanced practice physiotherapists and general practitioners

Themes

Subthemes

Axial codes

Both GPs’ trust in APP and a clear added value of APP are critical for starting implementation

GPs need to trust APP

 

GPs doubt added value of APP

 

APPs need continuous support from GPs

APPs need the full commitment of GPs to start

APPs cannot refer to secondary care on their own

Limited availability of patient information

Triaging patients lacks criteria

APPs and GPs want to scale-up

GPs and APPs struggle with who is in charge of the care pathway

APPs require support from GPs while they build-up their self-confidence

Insecurity during delivery of care

Insecurity during team interactions

More work experience increases their self confidence

Establishment of proper reimbursement is crucial

 

APPs believe that their position needs strengthening

GPs want to retain their authority and control

Competencies and attainment levels are poorly crystalised

Different preferences for type of employment and final responsibility

APPs experienced tension between GPs’ standards and their working methods

More guidance from the professional association is desirable

APPs want more backing from trade organisation

Trade organisation needs to be a driving force towards stakeholders

APPs found limited added value in the training they attended

Work experience influences the added value of the training

Curriculum needs more in-depth and practical training

Implementation of the APP model creates tension over ownership

No place for APP among physiotherapy yet

Gaining trust amongst physiotherapists with whom they need to collaborate

Controversy over the positioning of APPs

Finding the balance between taking over GP care and safeguarding core values

Deployment of APP jeopardises patient-centred care

Ensuring the independent delivery of care appears to be an unfeasible ideal

GPs must be able to maintain the delivery of general medical care at a qualified level

APPs and GPs need to develop a common language