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“Well, it’s very doctor-related” – interprofessional communication and collaboration between GP practices and nurses in the ambulant setting: a qualitative study in southern Germany

BMC Health Services Research volume 25, Article number: 642 (2025) Cite this article

Abstract

Background

The demographic transition in Germany is leading to an increase in the number of people needing care or nursing services in their own homes. Interprofessional communication and collaboration among healthcare professions providing outpatient care is paramount to ensure effective and high-quality patient-centred care. However, interprofessional communication and collaboration comes with complex prerequisites and rarely works smoothly. Thus, it is necessary to assess the current status quo.

Therefore, the aim is to characterize communication patterns, factors influencing interprofessional communication and collaboration and expectations towards communication and collaboration between home-care nursing services and general practitioner practices in Germany.

Methods

Semi-structured interviews with healthcare professionals in general practitioners’ practices (n=7) and nurses working in home-care nursing services (n=10) were conducted in southern Germany. The interviews were analysed using inductive thematic content analysis.

Results

Current communication occurs via fax, telephone or personal contact for various purposes, including issuing or rectifying prescriptions and exchanging information about change in a patient’s condition. Key factors influencing interprofessional communication are organizational (e.g., lack of direct communication), profession-related (e.g., hierarchy) and individual (e.g., capacity to provide care). Interprofessional collaboration is scarce. Healthcare professionals expect uncomplicated, efficient and quick communication and collaboration through set channels.

Conclusions

Current interaction patterns are deficient and require political, structural and educational changes to establish well-functioning collaboration in the ambulant sector that facilitates patient-centred care. Educational and political reforms should comprise expanding interprofessional education in curricula and the introduction of clear and secure communication channels.

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Background

Most countries worldwide are experiencing demographic transition – the number of, for example, European citizens aged 65 or over is expected to rise by 41% in the coming three decades [1, 2]. For 2050, it is estimated that 22–27% of the German population will be older than 67 years as opposed to 20% in 2021 [3]. This in turn is associated with increased demand of healthcare services, as multimorbidity rises with age [4]. Due to the desire of many elderly people to be cared for in their own home, an increase of 42% in the number of persons using professional home-care nursing services is projected until 2050 [5].

In Germany, ambulant health and nursing care services are provided by a multitude of professionals, such as general practitioners (GPs) and medical specialists, pharmacists, nurses and physiotherapists, all of whom work separately and in accordance with the different pillars of the healthcare system, as mainly defined in the Social Code Books V and XI [6]. GPs are generally self-employed and cater to the medical needs of the population living in the vicinity of their practice. They employ medical assistants at their practice who are responsible for organizing GP practice procedures (such as documentation and billing for services) and patient flow, including appointment-making and other communication. Medical assistants are the first point of contact at the GP practice, including home-care nursing services and patients [7]. Home-care nursing services are heterogeneous in their organization, ranging from small local services to larger companies with branches all over Germany. They provide in-home care services, such as nursing diagnosis and interventions, counselling, body-related care measures and administration of medicines [8]. While patients have free choice of healthcare provider and home-care nursing service, nursing services must generally first be prescribed, normally by the GP, in order to access service provision and reimbursement [6].

As multimorbid patients receive care from these different healthcare provider, interprofessional communication and collaboration among diverse healthcare professions in the ambulatory setting are needed to ensure effective and high-quality patient-centred care [9,10,11].

For the purpose of this paper, we define interprofessional communication as the “ability to translate information openly, accurately and in a timely manner” between professions [12] and interprofessional collaboration as “different health and social care professions meeting regularly to negotiate and agree on how to solve complex care problems or deliver services” [13]. Communication is thus a key element of collaboration and forms the basis for trusting interprofessional relationships [14].

Interprofessional communication and collaboration might, however, be hampered by a multitude of challenges. One main challenge lies in the fragmented organizational and financial structure of the German healthcare system which reimburses inadequately for interprofessional coordination and communication activities [6, 15]. Especially in home-care, interprofessional collaboration is challenging [11]. Challenges to interprofessional communication and collaboration and effective patient care might further be exacerbated by (i) a shortage of approximately 3,300 GPs, aggravated by the retirement of GPs with few young GPs to replace them, who then work less hours and conduct fewer home visits [16,17,18,19] and (ii) a lack of at least 35,000 skilled nurses [20], resulting in the need to recruit foreign staff.

With this study, we want to contribute to the body of knowledge relating to the current challenges to interprofessional communication and collaboration between home-care nursing services and GP practices in Germany, as perceived by the healthcare professionals. The aim of this paper is to characterize communication patterns, the factors influencing interprofessional communication and collaboration, and the expectations towards communication and collaboration between home-care nursing services and GP practices in Germany.

Methods

Participant recruitment and data collection

We conducted a qualitative study in a semi-urban region in southern Germany, encompassing the town of Kempten in Bavaria with about 70,000 inhabitants and the rural district of Upper Allgäu around it. Reporting within this paper adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ) to ensure quality [21]. Semi-structured interviews were conducted with (1) healthcare professionals in GP practices and (2) nurses working in home-care nursing services. The interview guide was developed systematically according to Helfferich [22] by collecting questions, verifying them against the aim of the study and subsequently sorting and summarizing them. The interview guide was tested with two nurses and a general practitioner and validated through discussion in an interdisciplinary scientific team. The final interview guide (see Supplementary Material 1) was devised along the themes: 1. current communication patterns between GPs and home-care nursing services (questions informed by previous empirical knowledge [23]) and 2) the introduction of sociotechnical information and communication technologies, above all, in the current context of the mandatory implementation of the telematics infrastructure in Germany. Besides open-ended questions, participants were asked to rate the quality of communication between GP practices and home-care nursing services from 1 (best) to 6 (worst) to open the discussion about the current quality of communication and provide factors influencing their judgement. We anticipated 30–45 min duration for each interview; the actual mean duration was 35 min (from the range 17–72 min). In total, 55 GP practices and 32 home-care nursing services in the target region were invited to participate in the study via post in early March 2023 and were reminded three weeks later via email and telephone. To boost GP participation in the study, we expanded the target region in June 2023 and invited GP practices via email and telephone invitations. Eligible participants needed to be above the age of 18 years, willing to provide written informed consent, to belong to one of the professional groups GPs, medical assistants, nurses (including those serving as nursing service manager), or trained nursing assistants, and be currently working in a GP practice or a home-care nursing facility in a specific region in southern Germany. We included these professional groups as they are the key population involved in communication and collaboration between home-care nursing services and GP practices.

Interviews were conducted by trained investigators with a background in qualitative research (KN, SS, FF, MS, MCR, PML) from April to July 2023 at either the participants’ workplace (n = 8), the interviewer’s office (n = 3), or via a videoconference tool (Zoom Video Communications, Inc.) (n = 6), according to the participant’s choice. We observed no variations in the answers with regard to the location of the interview. Of the researchers, four were female and two were male. They had a diverse background ranging from medicine to nursing, including public and global health and sociology. In most interviews, two researchers were present: one leading the interview and one note-taker. No other person was present in the room during the interviews. The researchers explained the study goals prior to the interviews. Following the interviews, participants responded to a socio-demographic questionnaire. The researchers took field notes during the interview, including interruptions and non-verbal cues, which they subsequently discussed and used for triangulation. We conducted in total 16 interviews with all contacted healthcare providers willing to participate. Of those interviews, one involved two participants from the same home-care nursing service due to time constraints of the participants. Towards the final interviews, no new themes arose and we concluded that data saturation was reached.

Data analysis

Interviews were audio recorded, transcribed and pseudonymized. The quotes presented within this manuscript include information on the profession (General Practitioner: GP; (deputy) home-care nursing service manager: NM), the sex (Male: M; Female: F) and the age of the participant in years. No repeat interviews were carried out and we did not send transcripts or findings to participants to comment on or correct. Interview transcripts were stored on a password-protected computer, accessible only to the research team, to protect the privacy and confidentiality of the participants.

Thematic content analysis according to Braun and Clark [24] was used to identify the main themes and subthemes inductively. KN and MS coded one interview with a GP independently; FF and MCR one with a nurse. The results were compared and synthesized to develop a preliminary coding framework. KN then coded the remaining interviews using MAXQDA version 2022 (VERBI Software GmbH), a qualitative data analysis software. Coding was reviewed by a second researcher (MCR) and differences settled between the researchers. The codes were then classified into profession-related and organizational factors, based on by Nieuwboer’s et al. [10] conceptualization who identified factors hindering doctor-nurse communication in an ambulatory setting through a qualitative study. We expanded the factors by a third one, titled ‘individual factors’ and summarized codes pertaining to current communication patterns under one theme as well. The analysis was conducted in German. For the purpose of this publication, quotes were translated from German into English and double-checked by the research team (original and translated version can be found in Supplementary Material 2).

Ethics

This study was approved in November 2022 by the Gemeinsame Ethikkommission der Hochschulen Bayerns (Joint Ethics Committee of the Bavarian Universities of Applied Sciences) under the number GEHBa-202211-V-084. The participants provided written informed consent prior to data collection and did not receive any compensation for their participation.

Results

Starting with the sociodemographic characteristics of the study participants, we present current communication patterns and factors that influence interprofessional communication and collaboration grouped into organizational, profession-related and individual factors. This is followed by an overview of the factors and expectations towards interprofessional communication and collaboration.

Sociodemographic characteristics

We interviewed six GPs and one medical assistant working in a GP practice, as well as ten nurses from home-care nursing services, of whom nine served as (deputy) home-care nursing service managers (Table 1). Of the 17 participants, three were women employed in a GP practice and six were women working in home-care nursing services. The participants from GP practices had been working for an average of 6.50 (± 4.86) years at their current practice which provided care to 1,250 (± 298) patients per quarter on average, of which about 15% received home-care nursing services. The GP practices were largely similar in their structure, with one self-employed GP employing several medical assistants. In contrast, home-care nursing services varied from small, familiar facilities with 12 employees and 55 clients to big enterprises with specialized IT departments, employing 120 people and caring for 500 clients.

Table 1 Characteristics of study participants and their facilities
Full size table

Current communication patterns

Means of communication

All GPs and nurses communicated primarily using traditional methods such as fax machines and telephones, while digital means such as email were infrequently used. Occasionally, and especially in urgent cases, nurses might physically visit the GP practice.

“Many things can be done by phone or by fax. So, if we can’t reach the doctors by phone, then we try to reach them by fax. Email, it’s really rather rare that you can reach the doctors by email. […] And quite often it is also the case that if we have no other chance of getting through, then we drive to the doctors, but that is the last solution.” (NM, F, 60)

Reasons for communication

The reasons for communication reported on both sides were to (i) issue prescriptions for e.g., medication and (ii) discuss a patient’s condition, such as the necessity of a home visit.

“If the home-care nursing service runs out of medication, or if a visit is requested, or if wound care is needed, they send us an electronic fax.” (GP, M, 51)

Contact person when communicating

All nurses typically communicated with the medical assistant and only in urgent cases directly with the GP. GPs reached out to the home-care nursing services only in case of follow-up questions. GPs evaluated the quality of contact, using a Likert scale ranging from 1 (best) to 6 (worst), at a level of 2–3. Conversely, nurses perceived the quality less favourably, assigning a 3–4.

“I would say 98% of the time, it is enough for us to correspond with the medical assistants. Sometimes the medical assistants then say they have to consult with the doctor and then they call us back.” (NM, F, 60)

Factors influencing interprofessional communication and collaboration

Organizational factors

Organizational factors negatively impacting interprofessional communication and collaboration included fragmentation of the setting, lack of direct and intersectoral communication, scarce personal contact and high workload.

Fragmentation of the setting

Home-care nursing services catered for patients attended to by different GPs, while GPs took care of patients from various home-care nursing services. All GPs that currently or previously worked in rural areas reported that their patients were served by fewer home-care nursing services compared to GPs in urban areas. The fact that documentation and information systems were not shared impeded automated transfer of information.

“Above all, we have the problem that, because we supply customers in the entire [Name of a region], we do not say: ‘Okay, we have 50% of the customers at one GP’, but we have all GPs from [Name of a place] to [Name of a place].” (NM, F, 29)

Lack of direct intersectoral communication

When the necessity for direct communication arose, most GPs in our sample reported difficulties in reaching the appropriate person in the home-care nursing services. Likewise, most nurses interviewed criticized the accessibility of the GP, emphasizing short opening hours and the absence of a dedicated communication channel for GP-nurse interaction as nurses relied on the same telephone number as patients, being in direct “competition with sick people” (NM, M, 47) and needing to wait in the loop. Some GPs and nurses alike further criticized the deficient intersectoral communication, such as between specialists and GPs or between acute care facilities and home-care nursing services.

“And then it is often not clear to me who is really my contact person [from the home-care nursing service].” (GP, F, 38)

“Communication is the classic way: telephone. This is becoming more and more difficult because, of course, in the practices the telephones are probably running hot and glowing.” (NM, M, 45)

Scarce personal contact

Even though nurses and GPs valued personal contact, which was thought to foster a productive work climate, opportunities for such interactions were limited mainly due to time constraints. GPs in rural areas reported more instances of personal contact than their urban counterparts.

“I find this personal contact, even if they [nurses] then come to me personally in the practice, for example, very important and very good.” (GP, M, 40)

High workload

Time constraints were thought to arise due to a high and rising workload perceived by most nurses and GPs alike, which negatively influenced the quality and efficiency of patient care and collaboration. Many GPs additionally perceived nurses as overburdened with documentation responsibilities and staff shortages.

“The practices, the medical assistants, they just give me the strong impression that they have such a run-up and such a run-in that they simply can’t cope with the work anymore. And that is very noticeable.” (NM, M, 30)

Profession-related factors

Profession-related factors impeding efficient interprofessional communication and collaboration encompassed hierarchy, responsibilities and rights, as well as education.

Hierarchy

GPs and nurses alike used words like “them” and “us” in their communication about one another. According to many nurses, the hierarchical thinking of GPs hindered effective collaboration – even though they reported that this was slowly changing. According to them, the hierarchical mindset that places GPs above nurses was also evident among medical assistants. As some nurses perceived themselves as the “eye and ear” of the patient, they demanded to be treated as an equal partner by GPs. While some GPs were more open to propositions from nurses, they stressed that the patients’ treatment was ultimately their decision and most GPs in our sample perceived themselves as having the authority to issue directives to nurses.

“Ultimately, the decision comes from my side, what is then prescribed.” (GP, M, 40)

“In my experience it always depends on the hierarchical thinking of the physicians how well or how badly what works.” (NM, F, 42)

Responsibilities

Some GPs perceived nurses as not wanting to carry responsibility, thus shifting it towards the GPs and overloading them with tasks. Most nurses interviewed, on the other hand, perceived the need to monitor the GPs’ work and criticized the current system of prescriptions as they depended on issuing correct prescriptions for reimbursement.

“I feel like it’s often more like, well, I sent a fax, then the doctor can take care of it.” (GP, M, 51)

“Things get lost. They [the GPs] have a medication plan from half a year ago again. They haven’t entered the data for people yet. I can understand all that, given the stress and the throughput that they have in the doctors’ offices. But you always have to keep a close eye on things.” (NM, M, 47)

Rights

A lack of right to access patients’ data further impeded the work of some nurses as they sometimes did not receive information about a patient whom they were jointly treating with the GP, due to data protection issues.

“The [doctors] are not really allowed to give me any information. As I said, I have some doctors who do it because they know that we are there every day. But there are doctors who don’t say anything.” (NM, F, 31)

Education

Both professions criticized the lack of knowledge of the other profession, claiming that it hampered their interprofessional collaboration. Some nurses, for example, highlighted that GPs’ lack of knowledge in practice management had a negative impact on the working climate and efficiency of their practice, while many GPs, on the other hand, mentioned the lack of knowledge concerning patient care and lack of experience on the part of nurses as hindering factors.

“The problem is that many doctors have never learned how to manage staff. And a lot stands and falls with the ladies or the medical assistants […]. If there is a good atmosphere, then you go into the practice, you notice that immediately, the practice is running, it is also well organized.” (NM, F, 42)

“In outpatient care, I sometimes have calls where I don’t really / where you can tell they [nurses] are just overwhelmed by the situation, but they can’t really assess what the problem is from a nursing point of view.” (GP, F, 38)

Individual factors

Individual factors hampering efficient interprofessional communication and collaboration included the capacity to provide and the perspective on care, initiative to initiate change and the effective use of language.

Capacity to provide care

Most GPs and nurses noted differences in the quality of care provided by different GP practices and home-care nursing services. Many nurses, for example, highlighted frequent instances where they received incorrect prescriptions, which they subsequently needed to rectify in a time-consuming process.

“And there are striking differences in care services. That simply has to be said.” (GP, M, 52)

“Because in the last two quarterly prescriptions in the last quarters that we requested, there were so many errors that we had to request at least 50% of the prescriptions again.” (NM, F, 60)

Perspective on care collaboration

Most nurses interviewed emphasized that the quality of collaboration was significantly influenced by individuals, i.e., the medical assistant or the GP, and the overall organization of the GP practice. While in some GP practices they received the necessary information or prescriptions promptly, delays were common in others. Notably, one nurse recounted an experience where a medical assistant explicitly said that she was not their “first priority”. GPs lamented not receiving complete and timely information from nurses, hindering their ability to engage in meaningful patient care. However, some nurses stated that before contacting the GP, they evaluated the need for GP contact thoroughly and tried to be accommodating in their contact. One nurse, for example, recounted requesting prescriptions early and sending return postage to cover this.

“Well, it’s very doctor-related. So, there are practices where you work very well together, where you also get it very quickly, even without much fuss. And there are practices where every request has to be discussed.” (NM, F, 29)

“Of course, it is sometimes annoying, yes, when certain things that are medically important are brought to our attention much too late.” (GP, M, 52)

Initiative to change

Regarding the initiative to change current communication and collaboration patterns, most nurses in our sample waited for GPs, who saw themselves as the initiators of improvement. However, some GPs stated that they would not initiate changes in communication patterns with others due to time constraints.

“We haven’t started the attempt [to improve communication methods with GPs] again. Because, as I said, I think that the GP practices must decide and have ideas as to what facilitation there is for this from their side or for ideas as to what would be useful.” (NM, F, 60)

Use of language

An additional factor influencing interprofessional communication and collaboration was the perceived insufficient language fluency of some nurses, which led to misunderstandings.

“That the [nurses] are very often not proficient in German and then communication is more difficult as a result.” (GP, M, 51)

Overview and expectations

The organizational, profession-related and individual factors influencing interprofessional communication between GPs and home-care nursing services are summarized in Fig. 1. To improve interprofessional collaboration, nurses wished for uncomplicated, efficient and quick communication, using set channels specifically for nurse-GP communication, such as a fax line or a face-to-face meeting. GPs and nurses alike desired a prioritization of patients’ well-being.

Fig. 1
figure 1

Organizational, profession-related and individual factors influencing interprofessional communication between GPs and home-care nursing services

Full size image

“In the ideal situation, the information simply arrives correctly. Back and forth, a simple, direct communication. The information gets there. It stays there. Yes, successful communication, as in all areas, that nothing gets lost, that everything arrives.” (NM, M, 47)

“After all, it’s not about our work, it’s always about the result for the customer.” (NM, M, 45)

Discussion

Currently, home-care nursing facilities and GP practices communicate mainly via fax or telephone. Occasionally, nurses would personally visit the GP practice. The communication serves various purposes, including issuing or rectifying prescriptions, the necessity for home visits or wound treatment and sharing information about a change in a patient’s condition. This study identified several key factors that influence interprofessional communication and collaboration: (1) Organizational factors encompassing the fragmentation and the lack of direct communication and personal contact with others, (2) profession-related factors (e.g., hierarchy and responsibilities) and (3) individual factors involving personal attributes, such as the capacity to provide and the perspective on care amongst others.

While our findings highlight challenges of nurse-GP communication and collaboration in the German outpatient care, these are not unique to the German setting: Our results are consistent with a number of studies that describe the same routes (fax, telephone and mail) and reasons for communication in ambulatory and hospital settings [11, 25,26,27,28]. Organizational factors influencing communication and collaboration, such as fragmentation of ambulant and specialist care with no shared information system [6, 10, 11, 29], lack of direct communication and personal contact [10, 30, 31], as well as the high workload [29, 32] have been identified in recent studies. The results of our study confirm further findings of previous studies, identifying profession-related factors such as hierarchy [10, 30,31,32,33,34], responsibilities and rights [28, 34] and education [28, 33] as impacting interprofessional communication and collaboration. Our results are in line with other studies identifying factors on an individual level, such as the capacity to provide care [30, 31], the perspective on care and initiative to change [34] and use of language [31].

Whilst most factors were identified in various papers, our study provides a comprehensive overview of the factors influencing GP-nurse communication and collaboration in the care for outpatients. It also considers unique aspects of the current situation in Germany, including the heavy reliance on fax machines and the fragmentation of the ambulant sector [6, 11].

Even though each factor has been presented under a specific category, they should not be seen as independent from one another. As already described by Sekanina et al. [11], nurses currently assume a mediating position between healthcare providers and patients or their relatives, e.g., as a support in coping with the illness or need for care [35]. They perceive themselves as the “ear and eye of the patient” and wish to be recognized as an “equal partner” in communication and collaboration with GPs to jointly achieve the best possible patient care (profession-related). However, due to the prevailing framework conditions, time constraints and organization of collaboration (organizational level), home-care nursing services are, for example, reliant on prescriptions from GPs and thus de facto dependent on them. Furthermore, even though there is a change in GPs’ mindset and some nowadays ask for nurses’ feedback, “hierarchical thinking” still prevails in many GPs (profession-related), which negatively impacts communication and collaboration. A change in a specific category might lead to changes on other levels, in the same way as a change in perception of the nursing role might impact factors on all levels. Several studies have shown that understanding each other’s roles, professional identities and clarity about the responsibilities of each profession can significantly improve GP-nurse collaboration and communication in the ambulant setting [36,37,38].

Implications and recommendations

According to the definitions provided in the introduction, the current interaction pattern between GPs and nurses cannot be classified as collaboration, because negotiation processes are scarce. Rather, it is purely information exchange in the sense of communication, although timeliness and efficiency should be increased. In order to improve nurse-GP communication and implement effective collaboration, on an organizational level, clear communication channels need to be established, which might be facilitated by the mandatory implementation of the telematics infrastructure in Germany [39].

Further policy recommendations include, amongst others, an adequate reimbursement of times dedicated to interprofessional communication and collaboration. This would incentivize individuals’ motivation to cooperate, enhancing interprofessional relationships and aiding the development of a mutual understanding of approaches, language and goals [40]. The establishment of ‘formal team meetings’ would further allow for a structured care coordination, sufficient time to discuss cases and exchange views on organizational issues [37, 41]. On an individual level, the development of a ‘common language’ might further be guided through structured communication tools and frameworks, such as the American Medical Director Association’s “Protocols for Physician Notification” or ISBAR (Introduction, Situation, Background, Assessment and Recommendation) [31, 42]. To facilitate long-term changes, interprofessional education should be incorporated in curricula of each healthcare profession, jointly with an ongoing on the job training [28, 36]. This intervention can promote trust, a shared understanding of objectives and counteract prevailing stereotypes [10, 36]. Another long-term change might further be the establishment of dedicated case management professionals who are responsible for structuring interprofessional teams caring for chronic patients [43, 44]. This goes along with further concepts of professionalisation within nursing care which are debated in the context of digitalization [45] but is also already visible in the differentiation of job profiles in nursing such as community health nursing or advanced nursing practice.

Limitations

The findings of this study contribute to the limited body of knowledge in interprofessional communication and collaboration between GPs and nurses in the ambulatory setting. It is worth noting that since no financial incentives were provided for participating in these interviews, those with a stronger interest in interprofessional exchange were more likely to do so, potentially leading to an under-representation of individuals with less interest in such exchange. As medical assistants are the first point of contact at the GP practice for home-care nurses and with only one medical assistant participating, we might have missed valuable viewpoints concerning the communication and collaboration between home-care nursing services and GP practices. Furthermore, the study was conducted in a specific region in Germany and it therefore might not be possible to generalize the results.

Conclusions

Interprofessional communication and collaboration between home-care nursing facilities and GP practices are influenced by factors on an organizational and individual level, as well as profession-related factors. Current interaction patterns are deficient and require changes on political, structural and educational levels to establish well-functioning collaboration in the ambulant sector that facilitates patient-centred care. The results of this study highlight the need to improve nurse-GP communication and to implement effective collaboration. Based on the factors identified as influencing nurse-GP interaction, educational and political reforms should be established. These may comprise (1) establishing and reinforcing interprofessional education in medical and nursing curricula and (2) defining professional roles and responsibilities to tackle individual and profession-related factors. As for organizational factors, there is a need for political reforms, such as introducing clear and secure communication channels.

Data availability

Data is available upon reasonable request from the corresponding author.

Abbreviations

COREQ:

Consolidated Criteria for Reporting Qualitative Research

GP:

General practitioner

NM:

Nursing service manager

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Acknowledgements

During the preparation of this work, the authors used ChatGPT 4.0 in order to improve readability and language. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

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  1. Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, Kempten, Germany

    Kim Nordmann, Stefanie Sauter, Marie-Christin Redlich, Patricia Möbius-Lerch, Michael Schaller & Florian Fischer

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  1. Kim Nordmann
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Contributions

FF, MS, MCR and SS conceptualized the study. KN, SS, MCR, PML, MS and FF contributed to data collection. KN, MCR, MS and FF analyzed the data. KN drafted the manuscript; SS, MCR, MS and FF revised the draft critically and provided important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Florian Fischer.

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Ethics approval and consent to participate

This study was approved in November 2022 by the Joint Ethics Committee of the Bavarian Universities of Applied Sciences (Gemeinsame Ethikkommission der Hochschulen Bayerns) under the number GEHBa-202211-V-084. The participants provided written informed consent prior to data collection and did not receive any compensation for their participation. The study was conducted in accordance with the Declaration of Helsinki.

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Not applicable.

Competing interests

FF serves as Associate Editor at BMC Health Services Research. All other authors declare that they have no competing interests.

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Nordmann, K., Sauter, S., Redlich, MC. et al. “Well, it’s very doctor-related” – interprofessional communication and collaboration between GP practices and nurses in the ambulant setting: a qualitative study in southern Germany. BMC Health Serv Res 25, 642 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12913-025-12819-1

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