Managing trust problems in multidisciplinary primary health care collaborations

While trust is recognized as a key element for successful collaboration in primary care, little empirical research has been done on the management of trust problems. This study examined how trust problems in primary care are managed by investing in coordination activities. Theory and methods: Both sociological and economic theories about trust are used. Data was collected within the Dutch ‘Primary Focus’ program of the Netherlands Organization for Health Research and Development. Characteristics of 66 multidisciplinary collaborations in primary care were measured by 198 interviews, with project leaders and two partners per project. Results: Legal forms and risk management were more likely used when a large diversity of disciplines is involved in the multidisciplinary collaboration. Trust issues caused by high monitoring problems appeared to be managed by informal contact. Contrary to our expectation, partners who worked together before were more likely to invest in risk management during their collaboration. Conclusions: Coordination activities in primary care collaborations vary by diversity of the partners involved, their shared history and potential monitoring problems. Discussion: Trust problems in multidisciplinary collaborations are managed using different coordination activities. Future research is needed to explore the influence of trust on the outcomes of the collaboration itself.