title: ["He is not that important anymore" : General practitioners in a specialized palliative home care setting from a patient's point of view].
abstract: BACKGROUND
  The outpatient medical care of palliative patients (PPs) has always fallen within the duties of general practitioners. Since the specialized palliative out-patient care (SAPV) legislation in 2007 palliative home care teams (PCTs) were established, providing holistic medical, nursing, and psychosocial support for patients with life-limiting illness and their care providers.
  
  
  OBJECTIVE
  The article explores the role of GPs in palliative home care settings with PCTs from the patient's perspective.
  
  
  METHODS
  From December 2014 to January 2015 we conducted 23 qualitative, semi-structured interviews with severely ill patients receiving specialist palliative care at home in Germany. The theory-based analysis followed the qualitative content analysis according to Mayring.
  
  
  RESULTS
  The expectations of PPs towards their GP in integrated palliative care were influenced by individual criteria such as availability, intensity and duration of the doctor-patient-relationship. In relation to the quality of the long-term relationship and more specifically for basic medical care GPs still play an important role. On the other hand, PCTs are becoming increasingly important. In addition to the pain-management and symptom control responsibilities, they meet the daily care needs of PPs and their caregivers by coordinating the care network as well as providing psychosocial support and 24/7-care.
  
  
  CONCLUSIONS
  Shifting of traditional tasks from GPs to PCTs influences the role of the GP. PCTs can unburden the GP from unrealistic expectations and improve the patients' quality of life. However, this leads to a tendency for reduced importance of the GP.
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland. Sven.Schwabe@ukb.uni-bonn.de.
authors.forename: Sven
authors.initials: S
authors.lastname: Schwabe
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.
authors.forename: Gülay
authors.initials: G
authors.lastname: Ates
authors.affiliation: Heidelberg School of Education, Universität Heidelberg, Heidelberg, Deutschland.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ewert
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre Nijmegen, Nijmegen, Niederlande.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hasselaar
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.
authors.forename: Michaela
authors.initials: M
authors.lastname: Hesse
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.
authors.forename: Lisa
authors.initials: L
authors.lastname: Linge-Dahl
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.|Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland.
authors.forename: Birgit
authors.initials: B
authors.lastname: Jaspers
authors.affiliation: Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.|Zentrum für Palliativmedizin, Malteser Krankenhaus Seliger Gerhard, Bonn/Rhein-Sieg, Deutschland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Radbruch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000523:psychology / Q000706:statistics & numerical data; D001294:Attitude to Health; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D058005:General Practitioners / Q000523:psychology / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations
keywords: General practitioner; Integrated palliative care; Outpatients; Palliative care team; Qualitative methods